Guidewire bias in rotational atherectomy in the angled lesion: evaluation based on the thickness of the ablated intima and media.
The effect of guidewire bias on angled-lesion ablation by rotational atherectomy (RA) was assessed by measuring the changes in vertical lumen diameter, horizontal lumen diameter and the intima-media thickness of the coronary artery, using intravascular ultrasound in 10 lesions with an angle greater than 10 degrees. The vertical and horizontal diameters significantly increased after RA. The intima-media thickness at the 4 orthogonal sites significantly decreased. There was a significant positive correlation between vertical diameter change and angle (r=0.642, p=0.045), but none between horizontal diameter change and angle. There was no correlation between intima-media thickness change at 0 degrees and angle; however, at 180 degrees there was a tendency to correlation with angle (r=0.602, p=0.066). These data suggest that in cases of angled lesions, the increase in vertical lumen diameter is caused more by ablation of the 180 degrees wall than by that of the 0 degrees wall, which is brought about by guidewire bias toward the vascular wall at 180 degrees.
Oishi
Yoshihiko
Y
Department of Cardiology, Hiroshima Prefectural Hiroshima Hospital, Japan.
Okamoto
Mitsunori
M
Sueda
Takashi
T
Hashimoto
Masaki
M
Karakawa
Shinji
S
Kambe
Masayuki
M
D000787:Angina Pectoris / Q000628:therapy; D017225:Atherectomy, Coronary / Q000009:adverse effects / Q000295:instrumentation* / Q000592:standards*; D015982:Bias; D017115:Catheter Ablation / Q000009:adverse effects; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology; D018084:Ultrasonography, Interventional