Urban P, Meier B, Finci L, de Bruyne B, Steffenino G, Rutishauser W
J Am Coll Cardiol. 1987 Sep;10(3):504-9. doi: 10.1016/s0735-1097(87)80191-2.
Coronary wedge pressure is the pressure recorded distal to a stenosis while the inflated balloon occludes the coronary artery during angioplasty. This pressure has been shown to reflect actual (visible) and potential (recruitable) collateral flow to the stenosed artery, distal to the angioplasty site. In 100 consecutive vessels (91 patients) for which coronary wedge pressure had been measured at the time of angioplasty, the long-term (7 +/- 3 months) angiographic results was evaluated. The overall angiographic restenosis rate was 37%. It was 52% (25 of 48) in arteries with a coronary wedge pressure greater than or equal to 30 mm Hg and 23% (12 of 52) in arteries with a coronary wedge pressure less than 30 mm Hg (p less than 0.01). The mean coronary wedge pressure was 30 +/- 10 mm Hg for vessels with restenosis and 26 +/- 9 mm Hg for those without restenosis (p less than 0.01). The prevalence of angiographically visible collateral flow was 42% and 29%, respectively (p = NS). Neither age, sex, presence of unstable angina, left ventricular function, number of diseased vessels nor initial and final transstenotic pressure gradient and degree of stenosis were significantly associated with the long-term outcome after angioplasty. Restenosis rate is significantly increased when coronary wedge pressure measured at the time of angioplasty is high (greater than or equal to 30 mm Hg). This suggests a negative influence of competitive collateral flow on long-term results of angioplasty.
冠状动脉楔压是在血管成形术期间，当充气球囊阻塞冠状动脉时，在狭窄远端记录到的压力。已表明该压力可反映在血管成形术部位远端，流向狭窄动脉的实际（可见）和潜在（可募集）侧支血流。在血管成形术时测量了冠状动脉楔压的连续100条血管（91例患者）中，评估了长期（7±3个月）血管造影结果。总体血管造影再狭窄率为37%。冠状动脉楔压大于或等于30 mmHg的动脉中，再狭窄率为52%（48条中的25条）；冠状动脉楔压小于30 mmHg的动脉中，再狭窄率为23%（52条中的12条）（p<0.01）。发生再狭窄的血管平均冠状动脉楔压为30±10 mmHg，未发生再狭窄的血管为26±9 mmHg（p<0.01）。血管造影可见侧支血流的发生率分别为42%和29%（p=无显著性差异）。年龄、性别、不稳定型心绞痛的存在、左心室功能、病变血管数量，以及初始和最终跨狭窄压力梯度和狭窄程度，均与血管成形术后的长期结果无显著相关性。当血管成形术时测量的冠状动脉楔压较高（大于或等于30 mmHg）时，再狭窄率显著增加。这表明竞争性侧支血流对血管成形术的长期结果有负面影响。
