[The mechanism of percutaneous transluminal balloon angioplasty as assessed by intracoronary ultrasound].
OBJECTIVE
To elucidate the mechanism of coronary balloon angioplasty intracoronary ultrasound imaging.


METHODS
Intracoronary ultrasound imaging was performed in 68 coronary arteries of 52 patients. Ultrasound images obtained at the treatment site before and after balloon angioplasty were analyzed quantitatively for cross-sectional lumen area, area enclosed by internal elastic lamina (IELA) and plaque area. Qualitative analysis included assessment of presence of dissection, plaque composition and plaque topography.


RESULTS
The internal elastic lamina area was significantly enlarged after balloon angioplasty [(6.67 +/- 1.45) mm(2) vs (8.14 +/- 1.13) mm(2), P < 0.05]. The difference between IELA before and after balloon angioplasty DeltaIELA was different among different plaques (fatty plaque 1.84 mm(2), fibrous plaque 1.52 mm(2), calcified plaque 0.40 mm(2), mixed plaque 1.23 mm(2)). 85% of the lesions had dissection in some degree after PTCA. Severe dissections occurred mostly in calcified lesions.


CONCLUSIONS
The improvement in lumen dimensions after coronary balloon angioplasty is a result of both vessel stretch, as demonstrated by a larger internal elastic lamina area at the treated site, and dissection. Calcified lesions will have less vessel stretch and severer dissection after balloon angioplasty.
Shen
Z
Z
Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
Zhu
W
W
Huang
C
C
Zeng
Y
Y
Han
D
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000628:therapy; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018084:Ultrasonography, Interventional