ABSTRACT
Background: Percutaneous coronary angioplasty remains one of the most commonly applied techniques in the management of coronary artery disease in patients with suitable coronary anatomy. However, one of the factors that limit its effectiveness is the occurrence of elastic recoil immediately after dilatation
Aim: To assess the incidence and magnitude of elastic recoil that occurs immediately after coronary angioplasty and to detect the clinical and angiographic predictors of this process
Patients and Methods: Forty ischemic heart patients who were scheduled for percutaneous transluminal coronary angioplasty [PTCA] with clinical diagnosis of stable angina, unstable angina or prior myocardial infarction [MI].Their ages ranged between 31-76 years; with a mean age of 49.47+/- 11.89 years. Thirty-six [90%] were males and four [10%] were female. Qualitative and quantitative coronary angiographic evaluation before, during, and after PTCA were done for all patients included in this study to detect the occurrence of elastic recoil, its magnitude, and its predictors
Results: All patients showed different degrees of elastic recoil; with an average of 0.56+/-0.43 mm. Elastic recoil was responsible for a mean cumulative loss of 18.84 +/- 14.19 and of theoretically achievable gain immediately after balloon deflation. The following factors were found to have a positive correlation with the increased incidence and degree of recoil: balloon over sizing, lesion calcification, and eccentricity of lesion. However, elastic recoil was not influenced by age, sex, coronary risk factors or the patient's clinical diagnosis [stable angina, unstable angina old MI]
Conclusion: Elastic recoil was extremely common and caused loss of nearly 20% of the potential gain obtained during maximal balloon inflation. The present study identified the predictors of this unwanted event: the use of an oversized balloon for dilatation, lesion calcification, and lesion eccentricity