Rensing B J, Hermans W R, Beatt K J, Laarman G J, Suryapranata H, van den Brand M, de Feyter P J, Serruys P W
Catheterization Laboratory, Thoraxcenter, Erasmus University, Rotterdam, The Netherlands.
Am J Cardiol. 1990 Nov 1;66(15):1039-44. doi: 10.1016/0002-9149(90)90501-q.
Little is known about the elastic behavior of the coronary vessel wall directly after percutaneous transluminal coronary angioplasty (PTCA). Minimal luminal cross-sectional areas of 151 successfully dilated lesions were studied in 136 patients during balloon inflation and directly after withdrawal of the balloon. The circumvent geometric assumptions about the shape of the stenosis after PTCA, a videodensitometric analysis technique was used for the assessment of vascular cross-sectional areas. Elastic recoil was defined as the difference between balloon cross-sectional area of the largest balloon used at the highest pressure and minimal luminal cross-sectional area after PTCA. Mean balloon cross-sectional area was 5.2 +/- 1.6 mm2 with a mean minimal cross-sectional area of 2.8 +/- 1.4 mm2 immediately after inflation. Oversizing of the balloon (balloon artery ratio greater than 1) led to more recoil (0.8 +/- 0.3 vs 0.6 +/- 0.3 mm, p less than 0.001), suggestive of an elastic phenomenon. A difference in recoil of the 3 main coronary branches was observed: left anterior descending artery 2.7 +/- 1.3 mm2, circumflex artery 2.3 +/- 1.2 mm2 and right coronary artery 1.9 +/- 1.5 mm2 (p less than 0.025). The difference was still statistically significant if adjusted for reference area. Thus, nearly 50% of the theoretically achievable cross-sectional area (i.e., balloon cross-sectional area) is lost shortly after balloon deflation.
经皮腔内冠状动脉成形术（PTCA）后冠状动脉血管壁的弹性行为鲜为人知。在136例患者中，对151个成功扩张病变的最小管腔横截面积在球囊扩张期间及球囊撤出后即刻进行了研究。为避免对PTCA后狭窄形状进行几何假设，采用了视频密度测定分析技术来评估血管横截面积。弹性回缩定义为在最高压力下使用的最大球囊的横截面积与PTCA后最小管腔横截面积之间的差值。球囊平均横截面积为5.2±1.6mm²，充气后即刻最小横截面积平均为2.8±1.4mm²。球囊过大（球囊动脉比大于1）导致更多的回缩（0.8±0.3对0.6±0.3mm，p<0.001），提示存在弹性现象。观察到3条主要冠状动脉分支的回缩存在差异：左前降支为2.7±1.3mm²，回旋支为2.3±1.2mm²，右冠状动脉为1.9±1.5mm²（p<0.025）。如果对参考面积进行校正，差异仍具有统计学意义。因此，在球囊放气后不久，理论上可达到的横截面积（即球囊横截面积）将近50%丧失。
