Clinical angiographic and histologic correlates of eetasia after directional coronary atherectomy

Nicoletta B. De Cesare, Jeffrey J. Popma, David Holmes, Ronald J. Dick, Patrick L. Whitlow, Spencer B. King, Cass A. Pinkerton, Dean J. Kereiakes, Eric J. Topol, Christian C. Haudenschild, Stephen G. Ellis

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23 Citations (Scopus)

Abstract

Directional coronary atherectomy can cause ectasia (final area stenosis < 0%), presumably due to an excision deeper than the angiographically "normal" arterial lumen. In a multicenter series in which quantitative coronary arteriography was performed after directional atherectomy in 382 lesions (372 patients), ectasia after atherectomy occurred in 50 (13%) lesions. By univariate analysis, ectasia was seen more often within the circumflex coronary artery (p = 0.008), in complex, probably thrombus-containing lesions (p = 0.015), and with higher device: artery ratios (p < 0.001). Ectasia occurred less often in lesions within the right coronary artery (p = 0.008). Histologic analysis demonstrated adventitia or media, or both, in all patients with angiographic ectasia. Repeat angiography was performed in 188 of 271 eligible patients (69%) 6.1 ± 2.4 months after atherectomy. Restenosis, defined as a follow-up area stenosis ≥ 75%, was present in 50% of patients without procedural ectasia and in 70% of patients with marked ectasia (residual area stenosis <-20%; p = 0.12). It is concluded that excision beyond the normal arterial lumen may occur after directional coronary atherectomy, related, in part, to angiographic and procedural features noted at the time of atherectomy. Restenosis tends to occur more often in patients with marked ectasia after coronary atherectomy.

Original languageEnglish (US)
Pages (from-to)314-319
Number of pages6
JournalThe American journal of cardiology
Volume69
Issue number4
DOIs
StatePublished - Feb 1 1992

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Coronary Atherectomy
Pathologic Dilatations
Atherectomy
Pathologic Constriction
Coronary Vessels
Angiography
Adventitia
Thrombosis
Arteries
Equipment and Supplies

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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Clinical angiographic and histologic correlates of eetasia after directional coronary atherectomy. / De Cesare, Nicoletta B.; Popma, Jeffrey J.; Holmes, David; Dick, Ronald J.; Whitlow, Patrick L.; King, Spencer B.; Pinkerton, Cass A.; Kereiakes, Dean J.; Topol, Eric J.; Haudenschild, Christian C.; Ellis, Stephen G.

In: The American journal of cardiology, Vol. 69, No. 4, 01.02.1992, p. 314-319.

Research output: Contribution to journalArticle

De Cesare, NB, Popma, JJ, Holmes, D, Dick, RJ, Whitlow, PL, King, SB, Pinkerton, CA, Kereiakes, DJ, Topol, EJ, Haudenschild, CC & Ellis, SG 1992, 'Clinical angiographic and histologic correlates of eetasia after directional coronary atherectomy', The American journal of cardiology, vol. 69, no. 4, pp. 314-319. https://doi.org/10.1016/0002-9149(92)90226-O
De Cesare, Nicoletta B. ; Popma, Jeffrey J. ; Holmes, David ; Dick, Ronald J. ; Whitlow, Patrick L. ; King, Spencer B. ; Pinkerton, Cass A. ; Kereiakes, Dean J. ; Topol, Eric J. ; Haudenschild, Christian C. ; Ellis, Stephen G. / Clinical angiographic and histologic correlates of eetasia after directional coronary atherectomy. In: The American journal of cardiology. 1992 ; Vol. 69, No. 4. pp. 314-319.
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