Lower expression of neutrophil adhesion molecule indicates less vessel wall injury and might explain lower restenosis rate after Cutting Balloon angioplasty

• Published in: Circulation (New York, N.Y.) N.Y.), 1998-06, Vol.97 (25), p.2511-2518
• Main Authors: INOUE, T, SAKAI, Y, HOSHI, K, YAGUCHI, I, FUJITO, T, MOROOKA, S
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Cardiology. Vascular system; Catheterization - methods; CD18 Antigens - blood; Cell Adhesion Molecules - biosynthesis; Confounding Factors (Epidemiology); Coronary Disease - blood; Coronary Disease - metabolism; Coronary Disease - therapy; Coronary heart disease; Down-Regulation; Female; Heart; Humans; Intercellular Adhesion Molecule-1 - blood; Macrophage-1 Antigen - blood; Male; Medical sciences; Neutrophils; Recurrence
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/01.cir.97.25.2511

The Cutting Balloon is a novel dilatation catheter for coronary angioplasty (InterVentional Technologies Inc). It produces longitudinal, microsurgical incisions in the vessel wall before the actual dilatation. It is assumed that these controlled surgical incisions relieve hoop stress and reduce vessel wall injury and eventually restenosis. However, no clinical indicator to support the theory of reduced injury has been described. Certain clusters of differentiation (eg, CD11, CD18 on the leukocytes) are implicated in leukocyte adhesion, increased permeability, and opsonization. Therefore, they might serve as clinical indicators of the injury level of the vessels after angioplasty. We randomly selected 64 patients with isolated left anterior descending coronary artery disease for either Cutting Balloon angioplasty or conventional balloon angioplasty. The expression of CD18 and CD11b on the surface of neutrophils was determined by flow cytometric analysis. Serum levels of soluble intercellular adhesion molecule-1 (sICAM-1) were also measured. The expression of both the CD18 and CD11b in the coronary sinus blood gradually increased and reached its maximum at 48 hours after angioplasty. The sICAM-1 levels in the coronary sinus serum also increased after angioplasty. Percentage increases of CD18 and CD11b expression and the increase of the sICAM-1 levels at 48 hours after angioplasty (as ratios to baseline values before angioplasty) were less in the Cutting Balloon angioplasty group than in the conventional balloon angioplasty group (CD18, 1.10+/-0.05 versus 1.31+/-0.05, P