The alpha-1 adrenergic blocking agent urapidil counteracts postrotational atherectomy "elastic recoil" where nitrates have failed.
Calcium antagonist pretreatment and intracoronary high doses of nitrates (9 mg of isosorbide dinitrate) do not counteract coronary vasoconstriction occurring after rotational atherectomy. In 30 patients undergoing Rotablator atherectomy, intracoronary injection of the alpha 1-sympathetic blocker urapidil abolished or prevented significant vasoconstriction occurring 15 minutes after the procedure despite repeated injections of nitrates.
Gregorini
L
L
Clinique Posteur, Unité de Cardiologie Interventionelle, Toulouse, France.
Marco
J
J
Bernies
M
M
Cassagneau
B
B
Pomidossi
G
G
Anguissola
G B
GB
Fajadet
J
J
D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D017225:Atherectomy, Coronary / Q000009:adverse effects*; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D003331:Coronary Vessels / Q000187:drug effects* / Q000503:physiopathology; D004351:Drug Resistance; D005260:Female; D006801:Humans; D007548:Isosorbide Dinitrate / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use*; D018340:Receptors, Adrenergic, alpha-1 / Q000187:drug effects*; D013997:Time Factors; D016896:Treatment Outcome; D014661:Vasoconstriction / Q000187:drug effects*; D014665:Vasodilator Agents / Q000627:therapeutic use*
D000317:Adrenergic alpha-Antagonists; D002121:Calcium Channel Blockers; D010879:Piperazines; D018340:Receptors, Adrenergic, alpha-1; D014665:Vasodilator Agents; C015568:urapidil; D007548:Isosorbide Dinitrate