Coronary angioscopy of abrupt occlusion after angioplasty

White, Christopher J., Ramee, Stephen R., Collins, T. J., Jain, S. P. and Escobar, A. (1995) Coronary angioscopy of abrupt occlusion after angioplasty. Journal of the American College of Cardiology, 25 7: 1681-1684. doi:10.1016/0735-1097(95)00112-H

Author White, Christopher J.
Ramee, Stephen R.
Collins, T. J.
Jain, S. P.
Escobar, A.
Title Coronary angioscopy of abrupt occlusion after angioplasty
Journal name Journal of the American College of Cardiology   Check publisher's open access policy
ISSN 0735-1097
Publication date 1995-06
Sub-type Article (original research)
DOI 10.1016/0735-1097(95)00112-H
Volume 25
Issue 7
Start page 1681
End page 1684
Total pages 4
Place of publication San Diego, CA, United States
Publisher Elsevier
Language eng
Formatted abstract
Objectives: This study used angioscopy to determine the specific cause of vessel occlusion after percutaneous transluminal coronary angioplasty and compared the angiographic and angioscopic lesion morphologies in this setting.

Background: Occlusion of a dilated coronary artery is the major cause of morbidity and mortality after coronary angioplasty. Attempts to reopen occluded vessels are either empirically guided or directed by angiography, which has inherent limitations. Angioscopy, the in vivo direct visualization of the endovascular surface, is potentially a more accurate means of identifying the cause of vessel occlusion after angioplasty.

Methods: Percutaneous coronary angioscopy was performed in 17 patients (17 vessels) after angiographic confirmation of postangioplasty vessel occlusion.

Results: Angioscopy demonstrated the primary cause of the postangioplasty occlusion to be dissection in 14 patients (82%) and intracoronary thrombi in 3 (18%). Compared with angioscopy, angiography was significantly less accurate in identifying the specific cause of the occlusion and correctly identified the cause of vessel occlusion in only 5 (29%) of 17 patients (p < 0.001), including 4 (29%) of 14 deep dissections and 1 (33%) of 3 occlusive thrombi.

Conclusions: Angioscopy specifically identified the cause of occlusion in every patient, with coronary dissection the predominant cause of abrupt occlusion after coronary angioplasty. However, angiography was unable to identifiy a specific cause for vessel occlusion in the majority of our patients. Angioscopy may therefore prove useful in selecting specific treatment strategies for patients with abrupt occlusion after angioplasty, such as stent placement, atherectomy, repeat dilation or thrombolysis.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 21 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 25 times in Scopus Article | Citations
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Created: Mon, 14 Mar 2011, 10:32:40 EST