Serruys P W, Di Mario C, Meneveau N, de Jaegere P, Strikwerda S, de Feyter P J, Emanuelsson H
Cardiac Catheterization Laboratory, Erasmus University, Rotterdam, The Netherlands.
Am J Cardiol. 1993 May 20;71(14):41D-53D. doi: 10.1016/0002-9149(93)90133-w.
The use of miniaturized pressure and velocity sensors mounted on angioplasty guidewires allows the simultaneous measurement of coronary blood flow velocity and transstenotic pressure gradient, 2 parameters that, combined, should perfectly characterize stenosis hemodynamics. The aim of this article is assessment of the changes in coronary blood flow velocity observed with a Doppler-tipped angioplasty guidewire in 35 patients undergoing balloon angioplasty. We also report our initial experience in 16 patients with the combined use of sensor-tip pressure and Doppler guidewires, and we discuss the application of new methodologic approaches for the study of the coronary circulation allowed by these techniques, such as the instantaneous assessment of the flow velocity/pressure and pressure gradient/flow velocity relations. Before and after angioplasty, flow velocity measurements were obtained distal to the stenosis, both in baseline conditions and after intracoronary injection of 8-12.5 mg of papaverine. The Doppler guidewire was left in place during the dilation procedure and the Doppler signal was continuously recorded during balloon inflation and after deflation to monitor the development of collateral flow, the restoration of flow after balloon deflation, the phase of postocclusive reactive hyperemia, and, incidently, the development of flow-limiting complications. Merits and pitfalls of several flow velocity parameters (average peak velocity, coronary flow velocity reserve, diastolic/systolic velocity ratio), as well as of parameters derived from the combination of pressure and velocity measurements (transstenotic pressure gradient/flow velocity relation and instantaneous diastolic hyperemic flow velocity/pressure relation) were evaluated in 35 patients with, and 37 without, significant coronary stenoses.(ABSTRACT TRUNCATED AT 250 WORDS)
在血管成形术导丝上安装小型化压力和速度传感器，可同时测量冠状动脉血流速度和跨狭窄压力梯度，这两个参数结合起来应能完美地表征狭窄血流动力学。本文旨在评估35例接受球囊血管成形术患者使用多普勒尖端血管成形术导丝时观察到的冠状动脉血流速度变化。我们还报告了16例联合使用传感器尖端压力和多普勒导丝的初步经验，并讨论了这些技术所允许的用于研究冠状动脉循环的新方法的应用，例如流速/压力和压力梯度/流速关系的即时评估。血管成形术前和术后，在狭窄远端测量流速，分别在基础状态下以及冠状动脉内注射8 - 12.5毫克罂粟碱后进行测量。在扩张过程中，多普勒导丝留在原位，在球囊充气和放气期间连续记录多普勒信号，以监测侧支血流的发展、球囊放气后血流的恢复、闭塞后反应性充血阶段，以及顺便监测限流并发症的发生。对35例有明显冠状动脉狭窄和37例无明显冠状动脉狭窄患者的几个流速参数（平均峰值流速、冠状动脉血流速度储备、舒张/收缩期速度比值）以及从压力和速度测量结合得出的参数（跨狭窄压力梯度/流速关系和即时舒张期充血性流速/压力关系）的优缺点进行了评估。（摘要截短于250字）
