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Haziness on coronary angiogram after percutaneous transluminal coronary angioplasty evaluated with angioscopy
1First Department of Internal Medicine, Kinki University School of Medicine, Osaka, Japan. kanamasa@med.kindai.ac.jp
Insights
Percutaneous transluminal coronary angioplasty can cause hazy angiograms due to surface disruptions and thrombi. Angioscopy reveals these structural changes, explaining the common haziness observed after the procedure.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Imaging
Background:
- Coronary angiography after percutaneous transluminal coronary angioplasty (PTCA) often exhibits haziness.
- This haziness is attributed to uneven contrast medium distribution at the angioplasty site.
- The underlying structural changes responsible for this phenomenon require detailed investigation.
Purpose of the Study:
- To identify structural changes causing angiographic haziness after PTCA using angioscopy.
- To correlate angioscopic findings with the degree of haziness observed on coronary angiograms.
- To elucidate the role of specific structural alterations in post-PTCA angiographic haziness.
Main Methods:
- Coronary angioscopy was performed on 35 patients post-successful PTCA.
- Angioscopic examination focused on the angioplasty sites to identify surface disruptions and thrombi.
- Angiographic haziness was assessed and compared with angioscopic findings.
Main Results:
- Angioscopy revealed large surface disruptions in 17 patients, small disruptions in 4, and thrombi in 24.
- Angiographic haziness was present in 24 of 35 patients.
- Haziness was significantly more pronounced in patients with large surface disruptions (88%) and white thrombi (100%) compared to those without.
Conclusions:
- Percutaneous transluminal coronary angioplasty can induce significant surface disruptions and thrombus formation.
- Large surface disruptions and white thrombi are key contributors to the angiographic haziness observed after PTCA.
- Angioscopy provides valuable insights into the structural basis of post-PTCA angiographic artifacts.
Abstract:
Coronary angiograms obtained after percutaneous transluminal coronary angioplasty are often hazy due to uneven distribution of contrast medium at the angioplasty site, In this study, structural changes resulting in haziness after percutaneous transluminal coronary angioplasty were identified angioscopically. The affected coronary arteries of 35 patients who underwent successful percutaneous transluminal coronary angioplasty were examined with angioscopy. Coronary angioscopic examination of the sites subjected to percutaneous transluminal coronary angioplasty revealed large surface disruptions in 17 cases, small surface disruptions in four cases, and thrombi in 24 cases. Angiographic haziness was recognized in 24 of 35 patients after percutaneous transluminal coronary angioplasty. Haziness on angiography was more significant in patients who exhibited large surface disruption (88% vs 50%, p < 0.05), and was significantly greater in patients who exhibited white thrombus (100% vs 56%, p<0.05). Moreover, it appears that percutaneous transluminal coronary angioplasty-induced large surface disruption and white thrombus likely play an important role in increasing haziness.