Journal «Angiology and Vascular Surgery» • 

1998 • VOLUME 4 • №3-4

THE EFFICACY OF PROLONGED REPEATED DILATATION OF THE CORONARY ARTERIES USING A PERFUSION BALLOON IN EXTENSIVE DISSECTIONS OF VARYING DIRECTIONS

S.A. Abugov, Yu.M. Saakyan, O.V. Sankov, M.V. Puretsky, B.A. Rudenko, Ye.V. Sokolova, S.A. Davydov, V.A. Salimov, Yu.V. Belov
Russian Scientific Centre of Surgery, Russian Academy of Medical Sciences,
Moscow, Russia

The study comprised 81 patients with coronary artery disease (CAD), who underwent balloon coronary angiopiasty of one artery resulting in the development of extensive dissection of the intima and media of the dilated artery. To control extensive dissections, prolonged repeated dilatation using a perfusion balloon was applied in all the cases. All extensive dissections were divided into two types as dependent on the direction and orientation of free detached flaps of the vascular intima and media with respect to blood flow. The group with antegrade dissections included 43 patients. The group with retrograde extensive dissections included 38 patients. As a result of the study the positive angiographic effect was reached on the whole in 85.2% of patients. This inturn depended on the direction of extensive dissection and was recorded significantly more often in patients with retrograde dissections, namely in 94.7% of cases as compared to those with antegrade dissections (76.7%), (p<0.05). On the whole the direct clinical effect of coronary angioplasty in patients with angiographically effective use of prolonged repeated dilatation using a perfusion balloon to control extensive dissections was observed in 75.4% of cases. The efficacy depended on the direction of extensive dissection and was recorded significantly more often in retrograde dissections, namely in 86.1% of patients as compared to 63.6% of patients with antegrade dissections (p<0.05).

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