Heart and Vessels

, Volume 10, Issue 2, pp 106–110 | Cite as

Rheological significance of tandem lesions of the coronary artery

  • Yasumi Uchida
  • Fumitaka Nakamura
  • Takanobu Tomaru
  • Atsuko Miwa
  • Toshihiro Morita


It is not known whether the individual lesions that constitute tandem lesions of the coronary artery are developmentally or rheologically related. Luminal changes and their rheological significance were examined by percutaneous angioscopy in 44 tandem lesions of 21 patients with ischemic heart disease. Angioscopically, individual narrowing of angiographically documented tandem lesions appeared only as a tangentially expressed prominent portion of an atherosclerotic spiral fold. The directions of the fold were counterclockwise in the proximal to middle segments and clockwise in the distal segment of the right coronary artery, clockwise in the proximal to middle segments and counterclockwise in the distal segment of the left anterior descending artery, and counterclockwise in the proximal to middle segments of the left circumflex artery. The bloodstream always ran along the spiral folds in the tandem lesions. The results suggest that angiographically documented tandem coronary lesions are merely a tangential expression of atherosclerotic spiral folds and that they may act to prevent blood turbulence by generating a spiral laminal flow.

Key words

Percutaneous coronary angioscopy Tandem lesions Spiral folds Bloodstream Rheological significance 


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Copyright information

© Springer-Verlag 1995

Authors and Affiliations

  • Yasumi Uchida
    • 1
  • Fumitaka Nakamura
    • 1
  • Takanobu Tomaru
    • 1
  • Atsuko Miwa
    • 1
  • Toshihiro Morita
    • 1
  1. 1.Second Department of Internal MedicineUniversity of TokyoTokyoJapan

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