[Eccentric coronary stenoses--definition and incidence in coronary angiograms]

The frequency of "eccentric" stenoses was determined in 676 coronary angiograms, which proved to be useful to classify stenoses according to their position (central, eccentric), as well as to the form of residual lumen (round, not round). The results for 616 stenoses which could be evaluated for both position and form were: 30% (183/616) centrally located with round residual lumen; 10% (60/616) centrally located with no round residual lumen; 41% (255/616) eccentrically located with round residual lumen; 19% (115/616) eccentrically located with no round residual lumen. These results are in agreement with previous autopsy findings. The location and form of coronary stenoses may have different meanings: the prevalent round form of residual lumina (71% of all evaluated stenoses) may characterize a normal growing of stenoses, while no round forms might indicate complications such as ruptures with hemorrhage within plaques. The prevalent eccentric location of residual lumina (63% of all evaluated stenoses) may reflect a tendency to dynamic coronary tone within the respective coronary stenosis. This assumption is supported by similar frequencies of dilatative or constrictive responses in patients with coronary artery disease. Individual prognoses, however, with respect to coronary tone or coronary reactions cannot be predicted from morphology.