Serruys P W, Juillière Y, Zijlstra F, Beatt K J, De Feyter P J, Suryapranata H, Van Den Brand M, Roelandt J
Thoraxcenter, Erasmus University, Rotterdam, The Netherlands.
Am J Cardiol. 1988 Feb 1;61(4):253-9. doi: 10.1016/0002-9149(88)90926-5.
To investigate the clinical usefulness of intracoronary Doppler recordings during percutaneous transluminal coronary angioplasty (PTCA), the changes of intracoronary blood flow velocity during PTCA were assessed in 20 patients with single proximal coronary stenosis, using a Doppler probe end-mounted on the tip of a PTCA catheter. A mean of 4 inflations was performed in each patient. Intracoronary velocities were measured before and after each inflation and during peak reactive hyperemia after each transluminal occlusion. Quantitative analysis of the coronary stenosis was assessed before and after PTCA, and the dilatation resulted in an increase in minimal luminal cross-sectional area from 1.1 +/- 0.8 to 2.7 +/- 1.2 mm2. A gradual and significant improvement in velocities was observed after the first 3 dilatations, but in 15 of the 20 patients the resting and hyperemic velocities were not affected by the fourth dilatation. Coronary flow reserve measured during reactive hyperemia after the last dilatation with the PTCA catheter across the lesion was 1.9. This value of coronary flow reserve is compatible with the residual stenosis measured after PTCA when corrected for the presence of the Doppler balloon catheter (0.68 mm2). This application of the Doppler technique may provide a new method of on-line functional monitoring of the PTCA procedure in individual patients, but does not yet allow an accurate prediction of the change in coronary geometry brought about by PTCA.
为研究经皮腔内冠状动脉成形术（PTCA）期间冠状动脉内多普勒记录的临床实用性，使用安装在PTCA导管尖端的多普勒探头，对20例单一近端冠状动脉狭窄患者PTCA期间冠状动脉内血流速度的变化进行了评估。每位患者平均进行4次充盈。在每次充盈前后以及每次腔内闭塞后的反应性充血峰值期间测量冠状动脉内速度。在PTCA前后评估冠状动脉狭窄的定量分析，扩张使最小管腔横截面积从1.1±0.8增加到2.7±1.2mm²。在前3次扩张后观察到速度逐渐且显著改善，但20例患者中有15例静息和充血速度未受第4次扩张影响。在最后一次使用PTCA导管穿过病变进行的反应性充血期间测量的冠状动脉血流储备为1.9。校正多普勒球囊导管的存在后，该冠状动脉血流储备值与PTCA后测量的残余狭窄（0.68mm²）相符。多普勒技术的这种应用可能为个体患者PTCA过程的在线功能监测提供一种新方法，但尚不能准确预测PTCA引起的冠状动脉几何形状变化。
