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December 1, 1988Circulation

Coronary artery vasoconstriction routinely occurs after percutaneous transluminal coronary angioplasty. A quantitative arteriographic analysis.

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Why the study?

Does continuous intravenous nitroglycerin prevent coronary artery vasoconstriction after uncomplicated single-vessel PTCA?

Population

Patients undergoing uncomplicated single-vessel percutaneous transluminal coronary angioplasty maintained on…

Comparison

Continuous intravenous nitroglycerin during and… vs No intravenous nitroglycerin

Design

Cohort

Follow-up

30 minutes

Authors

TFTim A. FischellGDG. C. DerbyTTTak-Ming Tse

Discussion

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Overview

Continuous IV nitroglycerin was associated with prevention of post-PTCA vasoconstriction; hypothesis-generating for randomized outcome trials.

Key Points

  • This research aims to understand how percutaneous transluminal coronary angioplasty (PTCA) affects coronary artery dimensions and if nitroglycerin can prevent vasoconstriction.
  • Analyzed coronary artery diameters in 10 patients during the first 30 minutes post-PTCA.
  • Five additional patients received intravenous nitroglycerin throughout the procedure.
  • Performed quantitative measurements via arteriography at multiple time points and treated with nitroglycerin.
  • Progressive vasoconstriction was observed in 10 out of 10 patients in the dilated and distal segments post-PTCA (mean loss of 30 +/- 4%).
  • Vasoconstriction was statistically significant at 30 minutes compared to earlier times (p < 0.001) and the control segment (p < 0.005).
  • No significant loss of diameter occurred in the five patients who received intravenous nitroglycerin.

Structured PICO

Does continuous intravenous nitroglycerin prevent coronary artery vasoconstriction after uncomplicated single-vessel PTCA?

P
Population
Patients undergoing uncomplicated single-vessel percutaneous transluminal coronary angioplasty (PTCA) maintained on oral diltiazem and aspirin
I
Intervention
Continuous intravenous nitroglycerin during and after the procedure
C
Comparator
No intravenous nitroglycerin (observation of spontaneous changes)
O
Outcome
Changes in segmental coronary artery diameters (vasoconstriction) during the first 30 minutes after PTCAsurrogate

Spontaneous coronary artery vasoconstriction routinely occurs after PTCA but can be prevented by continuous intravenous nitroglycerin, challenging the hypothesis that PTCA causes arterial paralysis.

Cite This Study

Fischell et al. (1988) studied this question.

synapsesocial.com/papers/69ce1c7e46f7b4c542387b8ahttps://doi.org/10.1161/01.cir.78.6.1323
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Abnormal vasomotor changes early after coronary angioplasty. A quantitative arteriographic study of their time course.1991 · 56 citations
  2. 2Coronary stenosis vasomotion during dynamic exercise before and after PTCA1989 · 19 citations
  3. 3Evidence for altered epicardial coronary artery autoregulation as a cause of distal coronary vasoconstriction after successful percutaneous transluminal coronary angioplasty.1990 · 64 citations
  4. 4Inappropriate constriction of small coronary vessels as a possible cause of a positive exercise test early after successful coronary angioplasty.1991 · 60 citations
  5. 5Percutaneous Transluminal Coronary Angioplasty Reverses Vasoconstriction of Stenotic Coronary Arteries in Hypertensive Patients1998 · 8 citations