INTRODUCTION: The transitory persistence of perfusion defects immediately after successful percutaneous coronary interventions to correct coronary stenosis is well known METHODS: To test the hypothesis that such perfusion abnormalities are associated with microcirculatory disorders caused by coronary microembolization we compared the intensity and extent of these perfusion defects detected using myocardial scintigraphy in groups of patients randomly assigned to coronary balloon angioplasty (BA) or to rotational atherectomy plus balloon angioplasty (RA + B). The clinical and angiography characteristics were comparable in both groups, as well as the success of the coronary angioplasty procedure. RESULTS: Before the percutaneous coronary intervention the myocardium defect index, related to the extent and severity of hypoperfusion, was comparable for the two groups, both under stress (AB = 7.72±1.91 vs. RA + B = 8.61±3.38) and at rest (AB = 3.11±1.22 vs. RA + B = 2.40±1.63). After the procedure, the perfusion defect index decreased for both groups during stress, but with statistical significance only in the AB Group = 3.96±1.40 vs. RA + B = 3.71±1.89. The difference between the two groups was greater at rest after the coronary intervention procedure: the defect index decreased with marginal significance for the AB Group to 1.46±0.66 and increased, though without statistical significance, for the RA + B Group to 3.47±1.92. CONCLUSION: These results are compatible with the notion that transitory persistence of perfusion defects after successful coronary angioplasty are dependent on microcirculatory disorders associated to microembolization during the procedure.
Microcirculation; Atherectomy, coronary; Angioplasty, transluminal, percutaneous coronary
