Coronary artery vasoconstriction routinely occurs after percutaneous transluminal coronary angioplasty. A quantitative arteriographic analysis.

摘要: To determine whether percutaneous transluminal coronary angioplasty (PTCA) increases artery luminal dimensions by stretching and injuring ("paralyzing") the smooth muscle of arterial wall, we prospectively analyzed spontaneous changes then intracoronary nitroglycerin-induced in segmental diameters during first 30 minutes after uncomplicated single-vessel PTCA 10 patients. Five additional patients received intravenous nitroglycerin throughout procedure to could prevent vasoconstriction PTCA. All were maintained on oral doses diltiazem aspirin at time study. Coronary arteriography was performed 2, 5, 15, 3 300 micrograms i.c. nitroglycerin. Quantitative measurements (computerized edge-detection) each time, segments centered dilated segment, distal a control vessel not manipulated with balloon catheter or guidewire. Progressive (defined as loss diameter that reversed nitroglycerin) observed (10 patients) but segment. The segment (mean, +/- 4%) highly statistically significant compared 2 5 (p less than 0.001) 0.005). There no five who In conclusion, 1) occurs routinely site dilatation despite pretreatment calcium channel blockers; 2) is rapidly can be prevented continuous administration procedure; 3) these results are incompatible hypothesis improves "paralysis"; 4) findings have implications concerning etiology prophylaxis abrupt closure