Heart 1998;79:608-612 ( June )
Validation of an automated technique for determining the mechanical characteristics of coronary arteries during balloon angioplasty: laboratory assessment with necropsy segments
a Regional Medical Physics Department, Freeman
Hospital, Newcastle upon Tyne NE7
7DN, UK, b Department of
Histopathology, Freeman Hospital
Correspondence to: Professor Murray.
Accepted for publication 12 November 1997
Objectives
To develop a technique for automatic
inflation of a percutaneous transluminal coronary angioplasty (PTCA)
balloon, with continuous measurement of the balloon pressure and
volume; to validate the technique for determining the mechanical
characteristics of coronary arteries.
MethodsDuring necropsy examination of the hearts
of nine patients, 17 coronary artery samples were obtained for
histological examination. A PTCA balloon was inserted into each artery,
and the balloon pressure and volume were measured continuously during
four repeat automatic inflations of the balloon.
ResultsOf the 17 arteries, eight showed elastic,
six plastic, and three fracture pressure-volume deformation
characteristics. For the plastic deformations, the first inflation
required a higher pressure than subsequent repeat inflations of 82 (61) kPa (mean (SD), range 25 to 175 kPa). For the three in the
fracture group, the pressure drop because of the fracture occurred
between 210 and 540 kPa. Two of these three showed a tear on visual
inspection, and the other showed disruption of the intimal plaque on
blinded histological examination. Of the six with plastic deformation characteristics alone, one showed a tear, and on histological examination two others showed splitting of the internal and external elastic lamina and one showed separation of intima and media. None in
the elastic group showed any of these characteristics.
ConclusionsPlastic and fracture deformation
characteristics could be differentiated from elastic characteristics.
Visual or histological evidence of fracturing was present in all three
arteries identified during angioplasty as having pressure-volume
fracture characteristics.
© 1998 by Heart
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