title: Coronary vessel diameters during and after primary percutaneous coronary artery intervention.
abstract: BACKGROUND
  Primary percutaneous coronary intervention (P-PCI) is the gold standard treatment for acute coronary syndromes. Plasma levels of catecholamines and other vasopressors are elevated during acute myocardial infarction (AMI) and coronary vasoconstriction is frequent. We aimed to compare the reference vessel diameter (RVD) of the infarct-related artery (IRA) during primary PCI and after an average of 3 days.
  
  
  METHODS
  Coronary angiography (CAG) was performed on 58 patients with acute ST-segment elevation myocardial infarction (STEMI) and TIMI 3 flow after P-PCI (43 men, 15 women; mean age, 55.5 ± 10 years). TIMI 3 flow was achieved either by simple balloon dilatation and/or thrombus aspiration. Lesion length, RVD, minimal lumen diameter (MLD), mean vessel diameter (meanD), and area of stenosis were compared during P-PCI and follow-up CAG.
  
  
  RESULTS
  RVD, MLD, and meanD values were significantly higher during the follow-up CAG than after P-PCI (RVD 2.7 ± 0.7 mm vs. 2.9 ± 0.7 mm, p = 0.001; MLD 1.5 ± 0.5 mm vs. 1.7 ± 0.4 mm, p = 0.002; meanD 2.2 ± 0.5 mm vs. 2.4 ± 0.5 mm, p = 0.001). Area of stenosis values were significantly lower during the follow-up CAG than after primary PCI (69.5 ± 16.5 % vs. 62.1 ± 15 %, p = 0.001). Lesion lengths were not statistically significant during the follow-up CAG and primary PCI (lesion length 24.0 ± 10.8 mm vs. 22.1 ± 8.8 mm, p > 0.05).
  
  
  CONCLUSIONS
  This study showed that RVD was higher at the follow-up CAG a few days after AMI in patients who had TIMI 3 flow after P-PCI with simple balloon dilatation and/or thrombus aspiration. A delay of a few days for stent implantation in P-PCI allows for larger-diameter stent use and may help to reduce stent thrombosis and restenosis rates.
authors.affiliation: Cardiology Department, Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Sahin
authors.forename: S
authors.initials: S
authors.lastname: Demir
authors.forename: G
authors.initials: G
authors.lastname: Kocabay
authors.forename: M
authors.initials: M
authors.lastname: Bulut
authors.forename: G
authors.initials: G
authors.lastname: Alici
authors.forename: B
authors.initials: B
authors.lastname: Ozkan
authors.forename: A
authors.initials: A
authors.lastname: Fedakar
authors.forename: M
authors.initials: M
authors.lastname: Turkmen
authors.forename: B
authors.initials: B
authors.lastname: Boztosun
mesh_terms: D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D003331:Coronary Vessels / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*; D009929:Organ Size; D062645:Percutaneous Coronary Intervention; D011184:Postoperative Period; D057234:Preoperative Period; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome