Angiographic classification of coronary dissections after plain old balloon angioplasty for prediction of regression at follow-up

Coronary dissection after plain old balloon angioplasty often shows regress ion during follow-up. This study sought to determine whether we can predict such phenomenon angiographically. We analyzed 64 patients with 71 type B-D coronary dissections determined by the National, Heart, Lung, and Blood In stitute (NHLBI) criteria. Regression was considered present when minimal lu men diameter increased by more than 0.3 mm during follow-up. Dissections we re divided into subgroups using the NHLBI criteria and our classification i n which type a and b dissections were characterized by the width of a disse ction lumen exceeding one quarter of the reference diameter with the outer edge of the dissection lumen within the boundary of reference in type a and beyond it in type b. In type c and type d dissections, the width of the di ssection lumen was within one quarter of the reference,vith its outer edge within the boundary of reference in type c and beyond it in type d. Type c dissection had a protruding flap or spiral appearance. Regression was recog nized in 23.9%. The distribution of dissection types was similar in the gro ups with and without regression by the NHLBl criteria, but type c dissectio n had regression more frequently than the other types of coronary dissectio ns (p <0.001) using Our classification.