Analysis of high-frequency rotational angioplasty-induced echo contrast.

During high-frequency rotational angioplasty (HFRA), myocardial contrast enhancement (echo contrast) was observed by means of two-dimensional echocardiography. In order to evaluate the echo contrast produced by HFRA, an in vitro experimental model was built using a cylinder with the HFRA catheter scanned in a water bath. The cylinder was filled with blood, mineral water, and distilled water. With a 2.5-MHz transducer, echograms were recorded and analyzed by video intensitometer, and the maximum intensity IUmax and persistence time P were calculated. Rotation frequencies of 20,000-200,000 rpm with 2.0--mm burrs and times of 10 s were tested. In another model, hyperbaric conditions for the same media were produced. The influence of debris from arterioscleroic plaque and of hematocrit on echo contrast intensity were also analyzed. The effect of HFRA on hemolysis (LDH, free hemoglobin) within 10 s and temperature were also measured. The contrast effect was transient, depending on the rotation frequency. In blood, it appeared at 20,000 rpm (IUmax at 200,000 rpm: 237 IU), in mineral water at 40,000 rpm (IUmax 165 IU), and in distilled water at 80,000 rpm (IUmax 72 IU). Persistence time was measured up to about a half-minute. Echo contrast production was reduced at 0.5 bar and fully suppressed at 2.5 bar. Debris increased contrast intensity from about 219 IU to 225 IU (at 160,000 rpm). In blood IUmax decreased from 227 IU to 97 IU by lowering the hematocrit from 44.2% to 3.6%.(ABSTRACT TRUNCATED AT 250 WORDS)

[1]  J. Ritchie,et al.  Rotational atherectomy in atherosclerotic rabbit iliac arteries. , 1988, American heart journal.

[2]  M. Wolverson,et al.  The direct visualization of blood flow by real-time ultrasound: clinical observations and underlying mechanisms. , 1981, Radiology.

[3]  B Meier,et al.  Restenosis after successful coronary angioplasty in patients with single-vessel disease. , 1986, Circulation.

[4]  R. Erbel,et al.  [Current complication rate of percutaneous transluminal coronary angioplasty in stable and unstable angina]. , 2008, Deutsche medizinische Wochenschrift.

[5]  M. Fishbein,et al.  Verification of myocardial contrast two-dimensional echocardiographic assessment of perfusion defects in ischemic myocardium. , 1984, Journal of the American College of Cardiology.

[6]  R. A. Silverman,et al.  Wave Propagation in a Turbulent Medium , 1961 .

[7]  J. Miles.  On the Reflection of Sound at an Interface of Relative Motion , 1957 .

[8]  B. Sigel,et al.  Effect of Plasma Proteins and Temperature on Echogenicity of Blood , 1981 .

[9]  R. Gramiak,et al.  Ultrasound cardiography: contrast studies in anatomy and function. , 1969, Radiology.

[10]  C. Tei,et al.  Myocardial Contrast Echocardiography: A Reproducible Technique of Myocardial Opacification for Identifying Regional Perfusion Deficits , 1983, Circulation.

[11]  A. Parisi,et al.  Hydrogen peroxide contrast echocardiography: quantification in vivo of myocardial risk area during coronary occlusion and of the necrotic area remaining after myocardial reperfusion. , 1984, Circulation.

[12]  R. Erbel,et al.  Detection of spontaneous echocardiographic contrast within the left atrium by transesophageal echocardiography: spontaneous echocardiographic contrast , 1986, Clinical cardiology.

[13]  G. Maurer,et al.  Correlation of myocardial echo contrast disappearance rate ("washout") and severity of experimental coronary stenosis. , 1984, Journal of the American College of Cardiology.

[14]  R. S. Mackay,et al.  Ultrasonic imaging of in vivo bubbles in decompression sickness. , 1971, Ultrasonics.

[15]  R. Erbel,et al.  High-frequency rotablation of occluded coronary artery during heart catheterization. , 1989, Catheterization and cardiovascular diagnosis.

[16]  Raimund Erbel,et al.  EIN PC-SYSTEM FÜR DIE VIDEO-INTENSITOMETRISCHE AUSWERTUNG VON KONTRASTECHOKARDIOGRAMMEN ZUR BEURTEILUNG DER MYOKARDPERFUSION IN ECHTZEIT. , 1989 .

[17]  M. S. Plesset,et al.  On the stability of gas bubbles in liquid-gas solutions , 1950 .

[18]  Randolph P. Martin,et al.  Left ventricular microcavitations in patients with beall valves , 1980 .

[19]  R. Erbel,et al.  [Current status of intracoronary balloon dilatation]. , 1987, Der Internist.

[20]  H. Shimokawa,et al.  Endothelium‐Derived Relaxing Factor and Coronary Vasospasm , 1989, Circulation.

[21]  D. Cumberland,et al.  Acute coronary occlusion during percutaneous transluminal coronary angioplasty. , 1985, British heart journal.

[22]  Ryozo Echigo,et al.  Experimental studies of the dissolution of gas bubbles in whole blood and plasma. I. Stationary bubbles. , 1971, Journal of biomechanics.

[23]  R Gramiak,et al.  Echocardiography of the aortic root. , 1968, Investigative radiology.

[24]  J. Douglas,et al.  In-hospital morbidity and mortality in patients undergoing elective coronary angioplasty. , 1985, Circulation.

[25]  Kenneth W. Cooper,et al.  Bubble formation in animals. I. Physical factors , 1944 .

[26]  R. Gramiak,et al.  Detection of intracardiac blood flow by pulsed echo-ranging ultrasound. , 1971, Radiology.

[27]  F J Ten Cate,et al.  Two-dimensional contrast echocardiography. I. In vitro development and quantitative analysis of echo contrast agents. , 1984, Journal of the American College of Cardiology.

[28]  E. N. Harvey,et al.  Bubble formation in animals. II. Gas nuclei and their distribution in blood and tissues , 1944 .

[29]  G. W. Willard.  Ultrasonically Induced Cavitation in Water: A Step‐by‐Step Process , 1953 .