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Intravascular Ultrasound Evaluation of Lumen Enlargement after Directional Coronary Atherectomy:A comparison with balloon angioplasty Toshiyuki Degawa 1 , Takahiro Nishida 1 , Kazuhisa Mitsuo 1 , Toshiyuki Asahara 1 , Tetsuzo Wakatsuki 1 , Tatsuo Akiyama 1 , Shigeru Nakamura 1 , Katsuto Ui 1 , Hiroko Tohma 1 , Yasunari Somitsu 1 , Taro Tsunoda 1 , Hideo Sakatani 1 , Nobuyuki Kobayashi 1 , Masato Nakamura 1 , So Yabuki 1 , Tetsu Yamaguchi 1 1Department of the 3rd Internal Medicine, Toho University Ohashi Hospital Keyword: DCA , PTCA , 血管内エコー法 , directional coronary atherectomy , balloon angioplasty , intravascular ultrasound pp.1099-1103
Published Date 1995/11/15
DOI https://doi.org/10.11477/mf.1404901147
  • Abstract
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To assess the results of lumen enlargement after directional coronary atherectomy (DCA), and conven-tional balloon angioplasty (angioplasty), intravascular ultrasound (IVUS) studies were performed after DCA in 16 patients (pts), and after angioplasty in 28 patients. Clinical demographics and angiographic lesion charac-teristics such as vessel size, lesion length, and pre-procedual lesion % diameter stenosis were similar in both groups. Lesion characteristics were ACC/AHA type A, B in all lesions of both group. The final balloon (device) /vessel size ratio were 1.1±0.1 in the DCA group, and 1.0±0.1 in the angioplasty group (NS). The IVUS lesion characteristics were similar in both groups. At the lesion sites; DCA Angioplasty Lumen CSA (mm2) 7.5±1.3 6.5±1.7 NS Vessel CSA (mm2) 17.0±1.9 15.0±3.1 NS % plaque area 54.8±9.4 56.1±8.5 NS At the proximal reference sites, lumen CSA, vessel CSA, plaque area and % plaque area did not differ in either group. The residual % lumen CSA stenosis (lumen CSA of the reference site-lumen CSA of the lesion site/lumen CSA of the reference site) was also smaller in both groups (26±12% vs. 25±18%, p<0.05). The incidence of medial dissection detected by IVUS was 6% in the DCA group, but 36% in the angioplasty group.(p<0.05)

Thus, this preliminary study showed that, compared with balloon angioplasty in selected patients. DCA can achieve similar lumen CSA without IVUS evidence of medial dissection. Randomized study is required to clarify the possible effectiveness of DCA in non-selected patients.


Copyright © 1995, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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