Virchows Archiv A

, Volume 410, Issue 3, pp 195–202 | Cite as

Percutaneous transluminal coronary angioplasty - Histopathological analysis of nine necropsy cases

  • Carlos Floriano de Morais
  • Edgard Augusto Lopes
  • Heddy Checchi
  • Shiguemitsu Arie
  • Fúlvio Pileggi
Article

Summary

From 1982 to 1984 nine of 300 patients undergoing transluminal coronary angioplasty died. The nine coronary arteries and one saphenous aorto-coronary by-pass graft affected by angioplasty were studied by light microscopy. The following types of lesions were found, frequently in association: rupture of the plaque, circumscribed or reaching to the intimal layer or extending beyond it, dissections (fissures) between arterial layers, intra-plaque haemorrhage, plaque emboli and thrombosis. In two cases the therapeutic approach was considered to be clinically and pathologically successful; the patients survived 24 h (case 6) and forty days (case 4). Case 6 which presented recent lesions indicative of success showed, in contrast with the other non-successful cases, rupture affecting not only the initimal layer but also deeper structures of the arterial wall. There were also more extensive fissures. Case 4 which presented late alterations indicative of success showed a plaque fracture whose borders were kept apart by fibrous tissue. In conclusion, we believe that angioplasty allows the re-establishment of arterial blood flow by provoking deep intimal and medial rupture producing a small fissure between the arterial layers and a widening of the lumen; in cases with good late results these alterations cicatrize leaving a wider arterial lumen.

Key words

Percutaneous coronary angioplasty Balloon angioplasty Coronary atherosclerosis 

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Copyright information

© Springer-Verlag 1986

Authors and Affiliations

  • Carlos Floriano de Morais
    • 1
  • Edgard Augusto Lopes
    • 1
  • Heddy Checchi
    • 1
  • Shiguemitsu Arie
    • 1
  • Fúlvio Pileggi
    • 1
  1. 1.Pathology and Hemodynamics Divisions of the “Instituto do Coração” (Heart Institute)Hospital das Clínicas, São Paulo Medical School, University of São PauloBrazil

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