Guidewire Bias in Rotational Atherectomy in the Angled Lesion : Evaluation Based on the Thickness of the Ablated Intima and Media

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The effect of guidewire bias on angled-lesion ablation by rotational atherectomy (RA) was assessed by measuring the changes in vertical lumen diameter, horizontal lumen diameter and the intima-media thickness of the coronary artery, using intravascular ultrasound in 10 lesions with an angle greater than 10°. The vertical and horizontal diameters significantly increased after RA. The intima-media thickness at the 4 orthogonal sites significantly decreased. There was a significant positive correlation between vertical diameter change and angle (r=0.642, p=0.045), but none between horizontal diameter change and angle. There was no correlation between intima-media thickness change at 0° and angle; however, at 180° there was a tendency to correlation with angle (r=0.602, p=0.066). These data suggest that in cases of angled lesions, the increase in vertical lumen diameter is caused more by ablation of the 180° wall than by that of the 0° wall, which is brought about by guidewire bias toward the vascular wall at 180°.
社団法人日本循環器学会の論文
2002-06-20