INFLUENCE OF HIGH-PRESSURE VERSUS LOW-PRE SSURE BALLOON ANGIOPLASTY ON POSTINTERVENTIONAL LUMINAL DIMENSIONS

In this study, we examined whether percutaneous coronary angioplasty ( PTCA) of native coronary arteries with high inflation pressure can imp rove the immediate postinterventional result in comparison to PTCA wit h nominal inflation pressure. Using quantitative coronary angiography, we analyzed the coronary angiograms of 24 patients who underwent PTCA with nominal inflation pressure (< 10 atm; group 1) and of 20 patient s who underwent PTCA with high inflation pressure (greater than or equ al to 10 atm; group 2). Only balloon catheters with little compliance were used. The following variables were recorded: 1) minimal luminal d iameter (MLD), reference diameter and percent diameter stenosis before and after PTCA, 2) average balloon diameter during PTCA, 3) balloon/a rtery diameter ratio, 4) acute luminal gain (difference between MLD be fore and after PTCA), 5) nominal elastic recoil (difference between no minal balloon diameter and MLD after PTCA), 6) actual elastic recoil ( difference between average balloon diameter during PTCA and MLD after PTCA). Nominal balloon diameter, reference diameter before and after P TCA and the balloon/artery diameter ratio were similar in both groups. Application of high inflation pressure resulted in a greater average balloon diameter. In group 2 (high inflation pressure), average balloo n diameter amounted to 94 a 12% of nominal balloon diameter, whereas i n group 1 (nominal inflation pressure), it reached only 84 +/- 9% of n ominal balloon diameter. Actual elastic recoil was not different betwe en the two groups. Nominal elastic recoil, however, was greater in the cohort which received PTCA with nominal inflation pressure (1.13 +/- 0.35 mm vs. 0.83 +/- 0.28 mm; p < 0.02). After use of high inflation p ressure, acute postinterventional luminal gain was significantly incre ased (1.04 +/- 0.25 mm vs. 0.77 +/- 0.34 mm; p < 0.02) and the postint erventional percent diameter stenosis was significantly lower(12 +/- 1 0% vs. 24 +/- 13%; p < 0.05). Application of high inflation pressure i mproves the postinterventional result after PTCA because of a greater acute luminal gain. The stenotic coronary artery is expanded to a grea ter degree, and actual elastic recoil remains unchanged.