Intracoronary blood flow velocity, reactive hyperemia and coronary blood flow reserve during and following PTCA
Developments in Cardiovascular Medicine, 1990
Since the introduction of percutaneous transluminal coronary angioplasty (PTCA) in 1977 [1], the ... more Since the introduction of percutaneous transluminal coronary angioplasty (PTCA) in 1977 [1], the procedure has gained increasing importance in the treatment of coronary artery obstructions. So far, the immediate results of the procedure have been assessed by coronary angiography and the residual pressure gradient. However, the change in luminal size of an artery following the mechanical disruption of its internal wall cannot be assessed accurately from the detected angiographic contours [2, 3]. The measured residual pressure gradient may have short and long-term prognostic value, but it reflects only the hemodynamic state at rest [4, 5, 6]. Recently the assessment of coronary flow reserve has been proposed as a better method to evaluate the functional results of dilatation of a coronary artery obstruction [7, 8, 9, 10]. Papaverine is currently regarded as the vasodilator of choice for the induction of maximal hyperemia, as intracoronary administration results in an immediate, potent and short-lasting hyperemia [11, 12]. Intracoronary blood flow velocity measurements with a Doppler probe, and the radiographic assessment of myocardial perfusion with contrast media have previously been used to investigate regional coronary flow reserve [13–17]. In the present study we compared both techniques in the setting of PTCA, and compared the pharmacologically induced vasodilation after intracoronary papaverine with reactive hyperemia following transluminal occlusion.
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Papers by Hans Reiber