Daniel W C, Pirwitz M J, Willard J E, Lange R A, Hillis L D, Landau C
Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas 75235-9047, USA.
Am J Cardiol. 1996 Aug 1;78(3):253-9. doi: 10.1016/s0002-9149(96)00273-1.
This study was performed (1) to assess the incidence and magnitude of elastic recoil occurring within 15 minutes of successful coronary angioplasty, and (2) to determine the effect of subsequent additional balloon inflations on coronary luminal diameter in patients displaying substantial recoil. The coronary angiograms of 50 consecutive patients who underwent a successful percutaneous transluminal coronary angioplasty were analyzed using computer-assisted quantitative analysis. The patients were divided into 2 groups based on the magnitude of early elastic recoil following angioplasty: those with < or = 10% (group I, n = 30) and those with > 10% (group II, n = 20) loss of minimal luminal diameter as assessed by comparing the angiogram obtained immediately after successful angioplasty with that obtained 15 minutes later. The 2 groups were similar in clinical, angiographic, and procedural characteristics. Of the 20 group II subjects, 18 (90%) underwent repeat balloon dilatations, and 2 patients (10%) had no further intervention. After additional balloon inflations were performed in these 18 patients, 16 (90%) had a final result with < 10% loss of minimal luminal diameter 15 minutes later. In conclusion, elastic recoil 15 minutes after apparently successful percutaneous transluminal coronary angioplasty is frequent, occurring in approximately 40% of patients, and is attenuated in 90% of subjects with additional balloon inflations. The resultant larger lumen diameter may exert a salutary effect on long-term outcome.
（1）评估成功进行冠状动脉血管成形术后15分钟内发生弹性回缩的发生率及程度；（2）确定在出现明显回缩的患者中，后续额外球囊扩张对冠状动脉管腔直径的影响。使用计算机辅助定量分析对50例连续成功接受经皮腔内冠状动脉血管成形术患者的冠状动脉血管造影进行分析。根据血管成形术后早期弹性回缩的程度将患者分为2组：通过比较成功血管成形术后立即获得的血管造影与15分钟后获得的血管造影，最小管腔直径损失≤10%的患者为I组（n = 30），最小管腔直径损失>10%的患者为II组（n = 20）。两组在临床、血管造影和操作特征方面相似。在II组的20名受试者中，18名（90%）接受了重复球囊扩张，2名患者（10%）未进行进一步干预。在这18名患者进行额外球囊扩张后，16名（90%）患者在15分钟后最终最小管腔直径损失<10%。总之，在明显成功的经皮腔内冠状动脉血管成形术后15分钟出现弹性回缩很常见，约40%的患者会发生，并且在90%进行额外球囊扩张的受试者中回缩减弱。由此产生的更大管腔直径可能对长期预后产生有益影响。
