Angiographic classification of coronary dissections after plain old balloon angioplasty for prediction of regression at follow-up.
Coronary dissection after plain old balloon angioplasty often shows regression during follow-up. This study sought to determine whether we can predict such phenomenon angiographically. We analyzed 64 patients with 71 type B-D coronary dissections determined by the National, Heart, Lung, and Blood Institute (NHLBI) criteria. Regression was considered present when minimal lumen diameter increased by more than 0.3 mm during follow-up. Dissections were divided into subgroups using the NHLBI criteria and our classification in which type a and b dissections were characterized by the width of a dissection lumen exceeding one quarter of the reference diameter with the outer edge of the dissection lumen within the boundary of reference in type a and beyond it in type b. In type c and type d dissections, the width of the dissection lumen was within one quarter of the reference with its outer edge within the boundary of reference in type c and beyond it in type d. Type e dissection had a protruding flap or spiral appearance. Regression was recognized in 23.9%. The distribution of dissection types was similar in the groups with and without regression by the NHLBI criteria, but type c dissection had regression more frequently than the other types of coronary dissections (p<0.001) using our classification.
Shigeyama
J
J
Division of Cardiology, Bisai City Hospital, Aichi, Japan.
Ito
S
S
Kondo
H
H
Ito
O
O
Matsushita
T
T
Okamoto
M
M
Toyama
J
J
Ban
Y
Y
Fukutomi
T
T
Itoh
M
M
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000145:classification / Q000000981:diagnostic imaging*; D023903:Coronary Restenosis / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000293:injuries* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged