[Usefulness of intracoronary ultrasound in percutaneous transluminal coronary angioplasty].
From February 1995 to April 1996 we performed intracoronary ultrasound (ICUS) in 32 patients who had percutaneous transluminal coronary angioplasty (PTCA). Eccentric plaques were found in 53% (n = 17) and concentric in 47% (n = 15). We found that 59.3% (n = 19) were soft, hard 21.8% (n = 7) and calcified plaques in 19% (n = 6). More than 40% of the plaques had some degree of calcium and most of them had dissection post PTCA ICUS deferred the procedure in 25% (n = 8) of cases. Seven of them were patients with late control post PTCA and no significant obstruction and a patient was found not to be a good candidate for PTCA. In 24 lesions we found morphology changes post PTCA: 41.6% type A, 12.5% type B, 45.8% type C, 8.3% type D, 90.9% type E1 and 9.1% type E2. Dissection was present in 54.1% post PTCA, ICUS information indicated other interventions (prolonged insufflations or stents). Two cases with acute coronary syndromes had smooth and fibrous plaques with excellent response to PTCA. Residual percentage stenosis post PTCA for quantitative coronary angiography was 23.7% and with ICUS 52.4%.


RESULTS
there were three cases with coronary spasm that responded well to nitroglycerin. In conclusion, ICUS provides information to evaluate results of PTCA. It also identifies complications and in some cases can improve results.
Ledesma
M
M
Hospital de Cardiología Centro Médico, Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México D.F.
Farell Campa
J
J
Flores Flores
J
J
Argüero Sánchez
R
R
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005069:Evaluation Studies as Topic; D006801:Humans; D014463:Ultrasonography