Document Detail


Coronary angioscopy of abrupt occlusion after angioplasty.
MedLine Citation:
PMID:  7759723     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This study used angioscopy to determine the specific cause of vessel occlusion after percutaneous transluminal coronary angioplasty and compared the angiographic and angioscopic lesion morphologies in this setting. BACKGROUND: Occlusion of a dilated coronary artery is the major cause of morbidity and mortality after coronary angioplasty. Attempts to reopen occluded vessels are either empirically guided or directed by angiography, which has inherent limitations. Angioscopy, the in vivo direct visualization of the endovascular surface, is potentially a more accurate means of identifying the cause of vessel occlusion after angioplasty. METHODS: Percutaneous coronary angioscopy was performed in 17 patients (17 vessels) after angiographic confirmation of postangioplasty vessel occlusion. RESULTS: Angioscopy demonstrated the primary cause of the postangioplasty occlusion to be dissection in 14 patients (82%) and intracoronary thrombi in 3 (18%). Compared with angioscopy, angiography was significantly less accurate in identifying the specific cause of the occlusion and correctly identified the cause of vessel occlusion in only 5 (29%) of 17 patients (p < 0.001), including 4 (29%) of 14 deep dissections and 1 (33%) of 3 occlusive thrombi. CONCLUSIONS: Angioscopy specifically identified the cause of occlusion in every patient, with coronary dissection the predominant cause of abrupt occlusion after coronary angioplasty. However, angiography was unable to identify a specific cause for vessel occlusion in the majority of our patients. Angioscopy may therefore prove useful in selecting specific treatment strategies for patients with abrupt occlusion after angioplasty, such as stent placement, atherectomy, repeat dilation or thrombolysis.
Authors:
C J White; S R Ramee; T J Collins; S P Jain; A Escobar
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  25     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1995 Jun 
Date Detail:
Created Date:  1995-06-23     Completed Date:  1995-06-23     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1681-4     Citation Subset:  AIM; IM    
Affiliation:
Department of Invasive Cardiology, HCI International Medical Center, Clydebank, Scotland, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Aneurysm, Dissecting / complications,  diagnosis
Angioplasty, Transluminal, Percutaneous Coronary*
Angioscopy
Coronary Aneurysm / complications,  diagnosis
Coronary Angiography
Coronary Disease / diagnosis*,  etiology,  therapy*
Coronary Thrombosis / complications,  diagnosis
Coronary Vessels / pathology*
Female
Humans
Male
Middle Aged
Recurrence

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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