Abnormal coronary vasoconstriction as a predictor of restenosis after successful coronary angioplasty in patients with unstable angina pectoris

Article Abstract:

Coronary heart disease results from the stenosis, or narrowing, of the major arteries of the heart by the progression of atherosclerosis. Transluminal angioplasty is a procedure which reopens the narrowed segments of arteries by inserting a balloon into the stenosed segment and inflating it, pushing back the 'hardened'' arterial walls. About a third of all patients for whom this procedure is initially successful will experience a restenosis of the affected arteries and will most likely have to endure bypass surgery. No treatment has yet been found which significantly affects the likelihood of restenosis. However, a first step in preventing restenosis would be the identification of the factors that contribute to it. One such factor has been found by researchers studying 106 patients who underwent transluminal angioplasty for unstable angina. (Angina is the chest pain associated with the temporary disruption of adequate blood flow to the heart; one of the many factors which may contribute to making some cases unstable is vasospasm, the sudden constriction of the affected arteries.) The patients were tested for a tendency for the coronary arteries to spasm; this test is performed by having the patient voluntarily hyperventilate. The patient breathes deeply and rapidly (at least 30 breaths per minute) for five minutes. The activity of the heart is monitored on the electrocardiograph (ECG) before, during, and after hyperventilation. Characteristic changes on the ECG recording indicate the presence of vasospasm. Arterial spasms were identified in 48 patients. Twenty-nine of these 48 (73 percent) suffered restenosis of the affected arteries after transluminal angioplasty. In contrast, restenosis occurred in 13 (25 percent) of the remaining 58 patients in whom arterial spasm was not identified. This observation suggests that vasospasm is an important risk factor for the failure of transluminal angioplasty to provide sustained benefit. The hyperventilation test is simple and fast, and may prove useful in determining the best course of treatment for patients with coronary heart disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Complications and side effects, Physiological aspects, Transluminal angioplasty, Balloon angioplasty, Hyperventilation, Coronary vasospasm

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Sirolimus-eluting vs uncoated stents for prevention of restenosis in small coronary arteries: A randomized trial

Article Abstract:

The study aims to determine whether sirolimus-eluting stents are associated with a reduced 8-month rate of angiographic restonosis in comparison with an uncoated stent. It concluded that the use of sirolimus-eluting stents to treat atherosclerotic lesions in small coronary arteries reduces restenosis and may also reduce major adverse cardiac events.

Prevention, Comparative analysis, Stent (Surgery), Stents, Sirolimus, Coronary restenosis

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Atherosclerotic plaque composition and occurrence of restenosis after carotid endarterectomy

Article Abstract:

A study to examine the connection between atherosclerotic plaque composition and the occurrence of restenosis after carotid endarterectomy is conducted. Results indicate that atherosclerotic plaque composition is associated with the risk of restenosis after carotid endarterectomy.

Health aspects, Risk factors, Endarterectomy, Stenosis, Atherosclerotic plaque, Clinical report

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