Ardissino D, Di Somma S, Kubica J, Barberis P, Merlini P A, Eleuteri E, De Servi S, Bramucci E, Specchia G, Montemartini C
Divisione di Cardiologia, Policlinico S. Matteo, Universita' di Pavia, Italy.
Am J Cardiol. 1993 Mar 15;71(8):659-63. doi: 10.1016/0002-9149(93)91006-4.
The elastic behavior of the dilated coronary vessel has been reported to affect the immediate results of coronary angioplasty. To determine whether elastic recoil may also influence the long-term restenosis process, 98 consecutive patients with unstable angina and 1-vessel disease were studied. An automated coronary quantitative program was used for the assessment of balloon and coronary luminal diameters. Elastic recoil was defined as the percent reduction between minimal balloon diameter at the highest inflation pressure and minimal lesion diameter immediately after coronary angioplasty. Follow-up coronary arteriography was performed 8 to 12 months after the procedure in all patients. The mean elastic recoil averaged 17.7 +/- 16% and was correlated to the degree of residual stenosis immediately after coronary angioplasty (r = 0.64; p < 0.001). Restenosis, defined as > 50% diameter stenosis at follow-up, developed in 53 patients (54%). There was no correlation between the degree of elastic recoil and the changes in minimal lesion diameter observed during follow-up, whereas a positive correlation between the amount of elastic recoil and the incidence of restenosis was documented (r = 0.84; p < 0.05). Thus, the elastic properties of the dilated vessel do not influence the active process of restenosis. However, because elastic recoil negatively influences the initial results of angioplasty, it is more likely that further reductions in lumen diameter during follow-up can reach a threshold of obstruction considered critical for a binary definition of restenosis.
据报道，扩张后的冠状动脉血管的弹性行为会影响冠状动脉血管成形术的即时效果。为了确定弹性回缩是否也会影响长期再狭窄过程，我们对98例连续的不稳定型心绞痛和单支血管病变患者进行了研究。使用自动冠状动脉定量程序来评估球囊和冠状动脉腔直径。弹性回缩定义为最高充盈压力下的最小球囊直径与冠状动脉血管成形术后即刻的最小病变直径之间的缩小百分比。所有患者在手术后8至12个月进行随访冠状动脉造影。平均弹性回缩为17.7±16%，并与冠状动脉血管成形术后即刻的残余狭窄程度相关（r = 0.64；p < 0.001）。53例患者（54%）出现再狭窄，定义为随访时直径狭窄> 50%。弹性回缩程度与随访期间观察到的最小病变直径变化之间无相关性，而弹性回缩量与再狭窄发生率之间存在正相关（r = 0.84；p < 0.05）。因此，扩张血管的弹性特性不会影响再狭窄的活跃过程。然而，由于弹性回缩对血管成形术的初始效果有负面影响，随访期间管腔直径的进一步缩小更有可能达到被认为对再狭窄二元定义至关重要的阻塞阈值。
