Circulation, Vol 76, 710-716, Copyright © 1987 by American Heart Association
ER Bates, MJ McGillem, TF Beals, SF DeBoe, JK Mikelson, GB Mancini and RA Vogel
To determine the effect of angioplasty-induced arterial injury on regional
coronary blood flow, resting and postocclusion reactive hyperemic flows
were measured in the left anterior descending (LAD) and circumflex (LCx)
coronary arteries of 32 dogs after one of four interventions in the LAD
with a balloon angioplasty catheter: group A, no injury; group B,
endothelial denudation; group C, medial injury; group D, pretreatment with
325 mg of aspirin 2 hr before medial injury. Resting flows did not change
in any group. In group C, hyperemic flow decreased in both the LAD and LCx
by 15% to 20% (p less than .001) over 30 to 90 min, suggesting that a
circulating substance changed coronary resistance. Histologic and
ultrastructural studies of the LADs demonstrated an intact endothelial cell
layer in group A, endothelial disruption with a few adherent platelets in
group B, medial injury with a dense layer of adherent platelets in group C,
and medial injury with a few adherent platelets in group D. Thus
endothelial denudation results in relatively mild platelet deposition and
no change in resting or hyperemic coronary blood flow. In contrast, medial
injury results in relatively marked platelet deposition and a significant
decrease in hyperemic flow, both of which are prevented by platelet
inhibition with aspirin.
ARTICLES
Effect of angioplasty-induced endothelial denudation compared with medial injury on regional coronary blood flow
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