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Effect of balloon inflation in angiographically normal coronary segments during coronary angioscopy: a quantitative
M Hamon1, J M Lablanche, C Bauters
1Service de Cardiologie B et Hémodynamique, Hôpital Cardiologique, Lille, France.
Insights
Coronary angioscopy uses an occlusive cuff that temporarily stops blood flow. This study found no significant changes in coronary lumen diameter at the cuff site after the procedure, indicating safety.
Area of Science:
- Cardiovascular Imaging
- Interventional Cardiology
Background:
- Coronary angioscopy visualization is aided by an occlusive cuff that interrupts blood flow.
- Animal models suggest endothelial denudation from cuff inflation may cause neointimal hyperplasia.
Purpose of the Study:
- To assess if coronary angioscopy cuff inflation causes significant changes in lumen diameter.
Main Methods:
- 52 patients undergoing coronary angioscopy were studied.
- Quantitative angiography (CAESAR system) measured lumen diameters before, after, and 6 months post-angioscopy.
- Cuff inflation site and control segments were analyzed.
Main Results:
- Mean and minimal lumen diameters at the cuff site showed no significant difference at 6-month follow-up compared to pre-angioscopy.
- Control segments also showed no significant changes.
- Late changes in lumen diameter at the cuff site did not differ significantly from control segments.
Conclusions:
- Coronary angioscopy with occlusive cuff inflation does not appear to cause significant late changes in coronary lumen diameter.
- The procedure is associated with stable lumen dimensions at the site of cuff application.
Abstract:
Visualization of coronary stenoses by coronary angioscopy is facilitated by inflating an occlusive cuff located near the distal end of the device to temporarily interrupt blood flow. In animal models, this procedure induces substantial endothelial denudation. Experimental studies show that endothelial denudation may lead to neointimal hyperplasia at the denuded site. This study was designed to determine whether angioscopy was associated with significant changes in lumen diameter at the site of cuff inflation. We studied 52 consecutive patients undergoing coronary angioscopy. We measured with use of quantitative edge-detection angiography [computer-assisted evaluation of stenosis and restenosis (CAESAR) system] the mean and minimal lumen diameters at the site of cuff inflation localized by filming the inflated cuff during angioscopy and at control non-instrumented segments on angiograms performed before angioscopy, after angioscopy, and at 6 months follow-up. Follow-up angiograms were performed in 80% of eligible patients. At follow-up, the mean (3.22 +/- 0.54 mm) and minimal (2.76 +/- 0.58 mm) diameters of the segment exposed to the inflated cuff were not significantly different from the equivalent values (3.22 +/- 0.58 and 2.75 +/- 0.61 mm) before angioscopy. No significant changes occurred in the mean or minimal diameters of the control segments over the same period. The late change (follow-up minus pre-angioscopy) in mean lumen diameter at the cuff inflation site (-0.005 +/- 0.18 mm) was not significantly different from that at the control site (0.004 +/- 0.20 mm).(ABSTRACT TRUNCATED AT 250 WORDS)