This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Leimgruber, P. P. Articles by Greuntzig, A. R. Search for Related Content PubMed PubMed Citation Articles by Leimgruber, P. P. Articles by Greuntzig, A. R.

Circulation, Vol 72, 530-535, Copyright © 1985 by American Heart Association

ARTICLES

Influence of intimal dissection on restenosis after successful coronary angioplasty

PP Leimgruber, GS Roubin, HV Anderson, CE Bredlau, HB Whitworth, JS Douglas Jr, SB King 3d and AR Greuntzig

We studied 986 patients who underwent follow-up angiography after successful percutaneous transluminal coronary angioplasty (PTCA) to determine the influence of uncomplicated intimal dissection on restenosis rate. Angiographic evidence of intimal dissection after PTCA was present in 248 patients or 25%. After a mean follow-up time of 7 +/- 5 months (SD) the restenosis rate in patients without intimal dissection was 30% compared with 24% in patients with intimal dissection (p = .08). Patients with available transstenotic pressure gradients were divided according to the hemodynamic result into two subgroups: those with final gradients at the conclusion of PTCA of 15 mm Hg or less (n = 638) and those with gradients greater than 15 mm Hg (n = 244). Patients with intimal dissection had a significantly lower restenosis rate than patients without intimal dissection if the final gradient was 15 mm Hg or less (19% vs 28%; p less than .05). If the final gradient was greater than 15 mm Hg, the presence or absence of intimal dissection had no significant influence on restenosis rate, which was 35% and 39%, respectively (p = NS). We conclude that an uncomplicated intimal dissection after a successful coronary angioplasty has no adverse influence on angiographic restenosis. An excellent angiographic long-term outcome can be expected if the intimal dissection is associated with a favorable hemodynamic result.

This article has been cited by other articles:

				M. Fenchel, A. Franow, N. I. Stauder, U. Kramer, U. Helber, C. D. Claussen, and S. Miller Myocardial Perfusion after Angioplasty in Patients Suspected of Having Single-Vessel Coronary Artery Disease: Improvement Detected at Rest-Stress First-Pass Perfusion MR Imaging--Initial Experience Radiology, October 1, 2005; 237(1): 67 - 74. [Abstract] [Full Text] [PDF]

				A. S. Roy, R. K. Banerjee, L. H. Back, M. R. Back, S. Khoury, and R. W. Millard Delineating the guide-wire flow obstruction effect in assessment of fractional flow reserve and coronary flow reserve measurements Am J Physiol Heart Circ Physiol, July 1, 2005; 289(1): H392 - H397. [Abstract] [Full Text] [PDF]

				A. Colombo, J. De Gregorio, I. Moussa, Y. Kobayashi, E. Karvouni, C. Di Mario, R. Albiero, L. Finci, and J. Moses Intravascular ultrasound-guided percutaneous transluminal coronary angioplasty with provisional spot stenting for treatment of long coronary lesions J. Am. Coll. Cardiol., November 1, 2001; 38(5): 1427 - 1433. [Abstract] [Full Text] [PDF]

				F. Alfonso Nonocclusive coronary dissections: to stent or not to stent? J. Am. Coll. Cardiol., July 1, 2000; 36(1): 303 - 304. [Full Text] [PDF]

				K. G. Lehmann, J. J. Popma, J. A. Werner, A. J. Lansky, and R. L. Wilensky Vascular remodeling and the local delivery of cytochalasin B after coronary angioplasty in humans J. Am. Coll. Cardiol., March 1, 2000; 35(3): 583 - 591. [Abstract] [Full Text] [PDF]

				A. Cappelletti, A. Margonato, G. Rosano, A. Mailhac, F. Veglia, A. Colombo, and S. L. Chierchia Short- and long-term evolution of unstented nonocclusive coronary dissection after coronary angioplasty J. Am. Coll. Cardiol., November 1, 1999; 34(5): 1484 - 1488. [Abstract] [Full Text] [PDF]

				D. P. Faxon Identifying the Predictors of Restenosis: Do We Need New Glasses? Circulation, May 6, 1997; 95(9): 2244 - 2246. [Full Text]

				M. J. Vonesh, L. F. Mockros, C. J. Davidson, K. B. Chandran, and D. D. McPherson In Vitro Identification of Angioplasty-Induced Injury by Use of Vascular Acoustic Emissions Circulation, February 18, 1997; 95(4): 1022 - 1029. [Abstract] [Full Text]

				M. R. Back, R. A. White, E. Y. Kwack, and L. H. Back Hemodynamic Consequences of Stenosis Remodeling During Coronary Angioplasty Angiology, February 1, 1997; 48(2): 99 - 108. [Abstract] [PDF]

				S. B. King III Angioplasty From Bench to Bedside to Bench Circulation, May 1, 1996; 93(9): 1621 - 1629. [Full Text]

				C. Bauters, J.-M. Lablanche, E. P. McFadden, M. Hamon, and M. E. Bertrand Relation of Coronary Angioscopic Findings at Coronary Angioplasty to Angiographic Restenosis Circulation, November 1, 1995; 92(9): 2473 - 2479. [Abstract] [Full Text]

				J. B. Wong, F. A. Sonnenberg, D. N. Salem, and S. G. Pauker Myocardial Revascularization for Chronic Stable Angina: Analysis of the Role of Percutaneous Transluminal Coronary Angioplasty Based on Data Available in 1989 Ann Intern Med, December 1, 1990; 113(11): 852 - 871. [Abstract] [PDF]