Pitfalls in the Application of Residual Coronary Pressure Gradient (RCPG) as an Indicator of Success or Failure of Transluminal Coronary Balloon Angioplasty
Available accessResearch articleFirst published online September, 1985
Pitfalls in the Application of Residual Coronary Pressure Gradient (RCPG) as an Indicator of Success or Failure of Transluminal Coronary Balloon Angioplasty
While the measurement of residual trans-stenotic coronary pressure gradi ent (CPRG) in the course of balloon angioplasty is a procedure of practical value in both estimating the severity of the stenosis and the degree of improve ment achieved, its application, however, has also several and serious sources of error; therefore, its value is limited and it should never be accepted as an out-of- context single indicator to either the degree of the stricture or of the anatomic improvement induced by angioplasty.
References
1.
Dotter CT, Judkins MP: Transluminal treatment of arteriosclerotic obstruction: Description of a new technic and a preliminary report of its application. Circulation30: 654-670, 1964.
2.
Block PC, Myler RK, Stertzer S., Fallon JT: Morphology after transluminal angioplasty in human beings. N Engl J Med305: 382-385, 1981.
3.
Grüntzig AR: Perkutane Dilatation von Coronarstenosen-Beschreibung eines meuen Kathetersystems . Med Keinwochenschrft54: 543-545, 1976.
Kent KM: Clinical status of percutaneous transluminal coronary angioplasty . Symposium on Coronary Intervention in Ischemic Syndromes. Stanford, California, March 13-14, 1981.
6.
Rothman MT, Baim DS, Simpson JB, Harrison DC: Coronary hemodynamics during percutaneous transluminal coronary arterioplasty . Am J Cardiol49: 1615-1622, 1982 .
7.
Robbins SL, Rodrigues FL, Wragy AL, Fish SJ: Problems in the quantitation of coronary atherosclerosis. Am J Cardiol18: 153-159, 1966.
8.
Chilvers AS, Thomas ML, Browse NL: The progression of atherosclerosis. A radiological study. Circulation50: 402-408, 1974.
9.
Brown BG, Bolson E., Frimer M., Dodge HT: Quantitative coronary arterioplasty. Estimation of dimensions, hemodynamic resistance and atheroma mass of coronary artery lesions using the arteriogram and digital computation. Circulation55: 329-337, 1977.
10.
Detre KM, Wright E., Murphy ML, Takaro T.: Observer agreement in evaluating coronary angiograms. Circulation52: 979-986, 1975.
11.
Grüntzig Senning A, Siegenthaler WE: Nonoperative dilatation of coronary artery stenosis. Percutaneous transluminal coronary angioplasty. N Engl J Med301: 61-68, 1979.
12.
Simpson JB, Baim DS, Robert EW, Harrison DC: A new catheter system for coronary angioplasty. Am J Cardiol49: 1216-1219, 1982.
13.
Milnor WR: Hemodynamics. Baltimore and London , Williams and Wilkins, 1982 .
14.
Seeley BD, Young DF: Effect of geometry on pressure losses across models of arterial stenosis . J Biomechanics9: 439-448, 1976.
15.
Young DF: Some factors affecting pressure-flow relationships for arterial stenoses . In: Mechanics of the Coronary Circulation. Ed. by Mates RE, Nerem RN, Stein PD.The American Society of Mechanical Engineers. New York, 1982, pp. 87-90.
16.
Mates RE, Gupta RL, Bell AC, Klocke FJ: Fluid dynamics of coronary artery stenosis. Circulation Research92: 152-162, 1978.
17.
Kreuzer W., Schenk WG: Effects of Local vasodilatation on blood flow through arterial stenoses . Eur Surg Res5: 233-242, 1973.
18.
Gould KL: In: Mechanics of the Coronary Circulation. Ed. by Mates RE, Nerem RN, Stein PD.The American Society of Mechanical Engineers. New York, 1982, pp. 51-53.
19.
Schwartz JS , Carlyle PF, Cohn JN: Effect of coronary arterial pressure on coronary stenosis resistance. Circulation61: 70-76, 1980.
20.
Santamore WP , Walinsky P.: Altered coronary flow reponse to vasoactive drugs in the presence of coronary stenosis in the dog. Am J Cardiol45: 276-285, 1980.
21.
Kirkeeide RL, Gould KL, Kelley KO: Fluid dynamic behavior of severe coronary stenoses: Classic rigid stenosis of collapsible Starling resistor. In: Mechanics of the Coronary Circulation. Ed. by Mates RE , Nerem RN, Stein PD.The American Society of Mechanical Engineers . New York , 1982, pp. 91-94.
22.
Knolton FP, Starling EH: The influence of variations in temperature and blood pressure on the performance of the isolated mammalian heart. J Physiol44: 206-219, 1912.
23.
Logan SE: On the fluid mechanics of human coronary artery stenosis. In: IEEE Transactions on Biomedical Engineering. Vol BME22, 1975, pp. 327-334.
24.
Gould KL, Kelley KO: Physiological significance of coronary flow velocity and changing stenosis geometry during coronary vasodilatation in awake dogs. Circulation Research50: 695-704, 1982.
