thesis
Transluminal coronary angioplasty : an investigational tool and a non operative treatment of acute myocardial ischemia
- Publication date
- 29 October 1986
- Publisher
- Since the introduction of coronary angioplasty in 1977, this procedure has gained
increasing importance in the treatment of coronary artery obstruction. From the
available evidence it can be estimated that this therapeutic tool will gain even
more momentum from the tens of thousands of patients who will be treated in the
next few years. Information about the indications, benefits and risks of the
coronary angioplasty is accumulating rapidly, in addition to publications about
refinements of the technique itself.
Recently, a number of investigators have realised that coronary angioplasty, is
not only a therapeutic tool, but can, during the procedure. be used as a source of
diagnostic information. When the catheter is placed across a coronary artery
obstruction, inflation of the balloon produces transient myocardial ischemia.
Before, during and after this period of severe ischemia studies of the performance
of the myocardium at risk can be carried out.
The fact that therapeutic coronary angioplasty is carried out in a cardiac
catheterization laboratory, which is by definition optimally equipped for the
measurements of hemodynamic parameters, has probably also contributed to the
execution of these investigations. The combination of hemodynamic and biochemical
parameters with morphological information from the coronary angiogram
can be utilized for the quantification of myocardial involvement and the
success of coronary artery dilatation with angioplasty. Studies of interactions with
pharmacological substances are also feasible and informative.
Coronary angioplasty has a most promising future as an unique means to gather
insight in the intricacies of myocardial oxygen supply and demand in patients with
coronary artery disease.