Trauma induced by nontraumatic coronary devices and its impact on vascular reactivity and morphology.
This study evaluated the impact of low-pressure balloon devices on coronary morphology and function. An active coronary perfusion catheter (2.5-mm balloon diameter, inflation with 1 bar for 30 min) was placed in the left anterior descending coronary artery of 12 German landrace pigs under general anesthesia. After 3 mo, coronary segments with balloon contact were compared with control segments taken from the right coronary artery as to histology, vascular reactivity, and expression of endothelial nitric oxide synthase. Thirty-three balloon treated segments were analyzed. Twenty of these segments (61%) showed neointima formation. In these segments endothelium-independent relaxation induced by sodium nitroprusside was preserved. However, endothelium-dependent bradykinin-induced relaxation was significantly attenuated compared with both the control segments and the balloon-treated segments without neointima formation. In >60% of the ballooned arterial segments examined, low-pressure balloon devices induced neointima formation accompanied by reduced endothelium-dependent relaxation. Thus interventions with so-called nontraumatic coronary devices can induce relevant vascular injury, with potential adverse clinical consequences.
Strotmann
Jörg M
JM
Medical University Clinic Würzburg, Germany. J.Strotmann@medizin.uni-wuerzburg.de
Bauersachs
Johann
J
Fraccarollo
Daniela
D
Kirchengast
Michael
M
Schnabel
Philipp A
PA
Sykora
Jaromir
J
Ertl
Georg
G
Voelker
Wolfram
W
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000295:instrumentation*; D000818:Animals; D001920:Bradykinin / Q000494:pharmacology; D023921:Coronary Stenosis / Q000209:etiology* / Q000473:pathology; D003331:Coronary Vessels / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D004730:Endothelium, Vascular / Q000187:drug effects / Q000201:enzymology / Q000473:pathology; D066298:In Vitro Techniques; D019001:Nitric Oxide Synthase / Q000096:biosynthesis; D052250:Nitric Oxide Synthase Type III; D009599:Nitroprusside / Q000494:pharmacology; D011312:Pressure / Q000009:adverse effects; D013552:Swine; D017539:Tunica Intima / Q000293:injuries* / Q000473:pathology; D014664:Vasodilation / Q000187:drug effects; D014665:Vasodilator Agents / Q000494:pharmacology
D014665:Vasodilator Agents; D009599:Nitroprusside; D019001:Nitric Oxide Synthase; D052250:Nitric Oxide Synthase Type III; D001920:Bradykinin