Abstract:
OBJECTIVES:The hypothesis of this study was that three-dimensional ultrasound imaging would facilitate the evaluation of arterial dissection after balloon angioplasty. BACKGROUND:The presence and extent of arterial dissection occurring at the time of balloon angioplasty may be important predictors of abrupt vessel closure or late restenosis. METHODS:Forty-one human arterial segments obtained after death were imaged in an in vitro system at physiologic pressure (80 to 100 mm Hg) before and after balloon angioplasty. Images were acquired with a 20- to 30-MHz mechanical intravascular ultrasound imaging system (Cardiovascular Imaging Systems) with a constant pullback technique (1 mm/s). Standard 0.5-in. (1.27-cm) video tapes were used for data storage and later playback for analog to digital conversion. Digitized data were reconstructed to three-dimensional images with use of voxel space modeling. The vessels were opened longitudinally and subjected to pathologic examination, photographed and classified histologically as normal, fibrous or calcified. Dissection was defined as a disruption and separation of components of the arterial wall. The length and depth of arterial dissection were evaluated grossly and microscopically. RESULTS:Of the 41 arteries studied, 36 (88%) exhibited dissection on pathologic examination after balloon angioplasty. Three-dimensional reconstruction of intravascular ultrasound images identified dissection in 11 (92%) of 12 normal, 8 (100%) of 8 fibrous and 11 (69%) of 16 calcified arteries. Excellent agreement between ultrasound and pathologic findings was achieved in the evaluation of length and depth of dissection for histologically normal and fibrous arteries (kappa = 0.72 to 1.0). When the vessels were severely calcified, the agreement was not as good (kappa = 0.27 to 0.56), particularly in detection of small, non-raised intimal flaps. CONCLUSIONS:This histopathologic validation study suggests that three-dimensional intravascular ultrasound imaging facilitates the evaluation of both quantitative and morphologic features of arterial dissection induced by balloon angioplasty. The advantage of three-dimensional intravascular ultrasound is its ability to assess the length and morphology of arterial injury over an entire vessel segment.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Coy KM,Park JC,Fishbein MC,Laas T,Diamond GA,Adler L,Maurer G,Siegel RJdoi
10.1016/0735-1097(92)90026-jsubject
Has Abstractpub_date
1992-09-01 00:00:00pages
692-700issue
3eissn
0735-1097issn
1558-3597pii
0735-1097(92)90026-Jjournal_volume
20pub_type
杂志文章abstract:OBJECTIVES:Parenteral L-arginine will improve myocardial ischemia in patients with obstructive coronary artery disease. BACKGROUND:Endothelial dysfunction causes coronary arterial constriction during stress, and L-arginine improves endothelial dysfunction. METHODS:Twenty-two patients with stable coronary artery disea...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2015-01-20 00:00:00
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更新日期:2006-07-04 00:00:00
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更新日期:2018-10-16 00:00:00
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