Kimball B P, Bui S, Cohen E A, Carere R G, Adelman A G
Department of Medicine, Toronto Hospital, Ontario, Canada.
Am Heart J. 1992 Dec;124(6):1459-66. doi: 10.1016/0002-8703(92)90057-3.
We evaluated intraprocedural "elastic recoil" in 25 patients (22 men and 3 women) undergoing directional coronary atherectomy (DCA) of left anterior descending stenoses, and compared these with 25 temporally-matched (14 men and 11 women) patients having balloon angioplasties (PTCA). Quantitative arteriography was performed using the Coronary Measurement System (Leiden, The Netherlands), with "elastic recoil" defined as the difference in maximum device or balloon size minus residual minimum diameter. In addition, we determined the effects of relative device size, specific anatomic location (proximal/mid artery), lesion length, eccentricity (symmetry index), and dystrophic calcification on acute "recoil" severity after both procedures. Although initial coronary stenoses were similar (minimum stenotic diameter, DCA = 0.59 +/- 0.20 mm versus PTCA = 0.55 +/- 0.23 mm, p = NS), less "elastic recoil" was observed after atherectomy (DCA = 0.83 +/- 0.57 mm versus PTCA = 1.26 +/- 0.56 mm, p < 0.01), and this was confirmed by absolute recoil/maximum device size ratios (DCA = 23.5 +/- 16.0% versus PTCA = 41.6 +/- 13.8%, p < 0.01). Acute "elastic recoil" was also influenced by maximum device size/"normal" coronary artery ratios [(ratio < 0.9, DCA = 0.26 +/- 0.10 mm versus PTCA = 0.84 +/- 0.13 mm, p < 0.01); (ratio 0.9 to 1.1, DCA = 0.69 +/- 0.41 mm versus PTCA 0.75 +/- 0.32 mm, p = NS); (ratio > 1.1, DCA = 1.09 +/- 0.64 mm versus PTCA = 1.59 +/- 0.48 mm, p < 0.05)].(ABSTRACT TRUNCATED AT 250 WORDS)
我们评估了25例（22例男性和3例女性）接受左前降支狭窄定向冠状动脉斑块旋切术（DCA）患者的术中“弹性回缩”情况，并将其与25例（14例男性和11例女性）进行球囊血管成形术（PTCA）且时间匹配的患者进行比较。使用冠状动脉测量系统（荷兰莱顿）进行定量血管造影，“弹性回缩”定义为最大器械或球囊尺寸减去残余最小直径的差值。此外，我们确定了相对器械尺寸、特定解剖位置（动脉近端/中段）、病变长度、偏心度（对称指数）和营养不良性钙化对两种手术后急性“回缩”严重程度的影响。尽管初始冠状动脉狭窄情况相似（最小狭窄直径，DCA = 0.59±0.20毫米，PTCA = 0.55±0.23毫米，p =无显著差异），但斑块旋切术后观察到的“弹性回缩”较小（DCA = 0.83±0.57毫米，PTCA = 1.26±0.56毫米，p <0.01），这通过绝对回缩/最大器械尺寸比值得到证实（DCA = 23.5±16.0%，PTCA = 41.6±13.8%，p <0.
