RESISTANCE OF THE ATHEROSCLEROTIC PLAQUE DURING CORONARY ANGIOPLASTY - A MULTIVARIATE-ANALYSIS OF CLINICAL AND ANGIOGRAPHIC VARIABLES

The atherosclerotic lesion resistance to balloon inflation was assesse d prospectively in 200 patients undergoing primary single-site balloon percutaneous transluminal coronary; angioplasty (PTCA) by using an id entical inflation protocol. This resistance was evaluated by the steno sis resolution pressure, which is the pressure at which the lesion mar k is no longer visible on the inflated balloon. The stenosis resolutio n pressure distribution was normal with a mean value of 4.4 +/- 2.3 at mospheres. Multivariate analysis revealed 4 factors related to the ste nosis resolution pressure: stable angina pectoris (p < 10(-6)), the pr esence of calcifications (p = 0.016), the occurrence of vessel wall di ssection after balloon angioplasty (p = 0.005), and the absence of a b ranch arising in the middle of the stenosis (p = 0.047). It is conclud ed that the mechanical resistance of the coronary lesion is related to the anginal status, the presence of calcifications, and the occurrenc e of vessel wall dissection after balloon angioplasty, probably on the basis of the plaque composition. (C) 1993 Wiley-Liss, Inc.