Rozenman Y, Gilon D, Welber S, Sapoznikov D, Gotsman M S
Cardiology Department, Hadassah University Hospital, Jerusalem, Israel.
Am J Cardiol. 1993 Nov 1;72(14):1020-5. doi: 10.1016/0002-9149(93)90856-8.
The effect of immediate recoil on the results of balloon angioplasty was examined in a group of 416 patients (596 lesions) who underwent successful coronary angioplasty. Immediate recoil was responsible for loss of 0.42 +/- 0.64 mm from the potentially achievable lesion diameter, and represented 23% of the actual gain in diameter. The immediate recoil was determined mainly by the degree of arterial stretch, which is best represented by the balloon to normal artery size ratio (correlation coefficient 0.49, p < 0.0001). Classic risk factors for coronary artery disease did not affect immediate recoil, except for a trend toward lower values in patients with history of hypercholesterolemia. There was a tendency for lower recoil in patients with residual coronary thrombus and in those who underwent angioplasty within 1 week of acute myocardial infarction. Recoil was larger in the left anterior descending artery than in the circumflex or the right coronary artery. Patients with more immediate recoil developed more restenosis (> 50% stenosis at follow-up). However the late loss of luminal diameter due to the restenotic process was smaller in those who had larger initial recoil. It is concluded that immediate recoil after balloon angioplasty is an elastic phenomenon that is related mainly to the degree of arterial stretch. The relative importance of immediate recoil in determining the late outcome of coronary angioplasty is at least as important as the late restenotic process.
在一组416例（596处病变）成功接受冠状动脉血管成形术的患者中，研究了即刻回缩对球囊血管成形术结果的影响。即刻回缩导致潜在可达到的病变直径损失0.42±0.64毫米，占直径实际增加量的23%。即刻回缩主要由动脉伸展程度决定，这最好用球囊与正常动脉大小之比来表示（相关系数0.49，p<0.0001）。冠状动脉疾病的经典危险因素不影响即刻回缩，除了高胆固醇血症病史患者有较低值的趋势。有残余冠状动脉血栓的患者以及在急性心肌梗死1周内接受血管成形术的患者有较低回缩的趋势。左前降支的回缩大于回旋支或右冠状动脉。即刻回缩较多的患者发生更多再狭窄（随访时狭窄>50%）。然而，在初始回缩较大的患者中，由于再狭窄过程导致的管腔直径后期损失较小。得出的结论是，球囊血管成形术后的即刻回缩是一种弹性现象，主要与动脉伸展程度有关。即刻回缩在决定冠状动脉血管成形术后期结果中的相对重要性至少与后期再狭窄过程一样重要。
