Clinical outcome of deferring angioplasty in patients with normal translesional pressure-flow velocity measurements

Objectives. The objective of this study was to determine the feasibility, safety and outcome of deferring angioplasty in patients with angiographically intermediate lesions that are found not to limit flow, as determined by direct translesional hemodynamic assessment. Background. The clinical import...

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Bibliographic Details
Published in:Journal of the American College of Cardiology 1995-01, Vol.25 (1), p.178-187
Main Authors: Kern, Morton J, Donohue, Thomas J, Aguirre, Frank V, Bach, Richard G, Caracciolo, Eugene A, Wolford, Thomas, Mechem, Carol J, Flynn, Michael S, Chaitman, Bernard
Format: Article
Language:English
Subjects:
Aged
Angioplasty, Balloon, Coronary
Biological and medical sciences
Blood Flow Velocity
Blood Pressure
Coronary Angiography - statistics & numerical data
Coronary Artery Bypass
Coronary Disease - diagnostic imaging
Coronary Disease - physiopathology
Coronary Disease - therapy
Coronary Vessels - physiopathology
Diseases of the cardiovascular system
Elective Surgical Procedures
Female
Follow-Up Studies
Humans
Male
Medical sciences
Middle Aged
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Reference Values
Time Factors
Treatment Outcome
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Summary:Objectives. The objective of this study was to determine the feasibility, safety and outcome of deferring angioplasty in patients with angiographically intermediate lesions that are found not to limit flow, as determined by direct translesional hemodynamic assessment. Background. The clinical importance of some coronary stenoses of intermediate angiographic severity frequently requires noninvasive stress testing. Direct translesional pressure and flow measurements may assist in clinical decision making in patients with such stenoses. Methods. Translesional spectral flow velocity (Doppler guide wire) and pressure data were obtained in 88 patients for 100 lesions (26 single-vessel and 74 multivessel coronary artery lesions) with quantitative angiographic coronary narrowings (mean ± SD diameter narrowing 54 ± 7% [range 40% to 74%]). Target lesion angioplasty was prospectively deferred on the basis of predetermined normal values, defined as a proximal/distal velocity ratio < 1.7 or a pressure gradient
ISSN:0735-1097
1558-3597
DOI:10.1016/0735-1097(94)00328-N