Cyclic flow variations after angioplasty: a rare phenomenon predictive of immediate complications. DEBATE Investigator's Group.
Experimental studies and studies in human beings have indicated that cyclic flow variation (CFV) is a reliable marker of the formation of platelet aggregates and thus may be predictive of immediate complications after coronary angioplasty. In this study, the incidence and clinical relevance of CFV in a large patient population after elective percutaneous transluminal coronary angioplasty (PTCA) was assessed. One hundred two patients with one-vessel disease and no previous Q-wave myocardial infarction underwent angiographically successful PTCA of a single lesion of a major coronary artery. A Doppler guide wire inserted distal to the stenosis was used to monitor flow velocity continuously after PTCA for 15 minutes. In 94 (92%) of 102 patients, a stable and reliable Doppler signal could be recorded for 15 minutes after the procedure. CFV, defined as gradual decline in flow over several minutes followed by a sudden restoration to higher values, was observed in 4 patients. In 3 of these 4 patients, the occurrence of CFV was predictive of immediate complications (2 intracoronary thrombosis and 1 acute closure), whereas none of the patients without CFV (n = 90) showed acute closure during hospital stay. In conclusion, CFVs in patients after angiographically successful elective PTCA are rare (4.3%) but highly sensitive for the prediction of abrupt occlusion.
Sunamura
M
M
Thoraxcenter, Erasmus University, Rotterdam, The Netherlands.
di Mario
C
C
Piek
J J
JJ
Schroeder
E
E
Vrints
C
C
Probst
P
P
Heyndrickx
G R
GR
Fleck
E
E
Serruys
P W
PW
D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis / Q000628:therapy*; D000789:Angina, Unstable / Q000175:diagnosis / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D001783:Blood Flow Velocity; D002932:Cineangiography; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis