SERIAL ANGIOSCOPIC AND ANGIOGRAPHIC OBSERVATIONS DURING THE FIRST HOUR AFTER SUCCESSFUL CORONARY ANGIOPLASTY - A PREAMBLE TO A MULTICENTER TRIAL ADDRESSING ANGIOSCOPIC MARKERS FOR RESTENOSIS

Percutaneous coronary angioscopy was used in 13 patients in a pilot st udy to assess the intracoronary changes that occur during the first ho ur after balloon angioplasty (PTCA). The dilated segment was studied w ith 4.5F angioscopes and with quantitative coronary angiography (QCA) immediately after PTCA and at 15-minute intervals for up to 1 hour aft er PTCA. Significant progression of intimal dissection and thrombus fo rmation could be demonstrated with angioscopy. These dissections and t hrombi remained undetected with angiography, which only showed hazines s. Thus through its superior sensitivity to intimal damage and thrombu s, coronary angioscopy can reveal important intravascular events that apparently occur even after successful PTCA. The relation of such angi oscopic observations to restenosis will be addressed in a subsequent m ulticenter study.