CORONARY BALLOON ANGIOPLASTY DISSECTIONS - THE GOOD, THE BAD AND THE UGLY

Since the introduction of percutaneous coronary balloon angioplasty nearly 15 years ago (1), there has been considerable interest in the recognition of angiographic patterns of successful dilation, angiographic predictors of angioplasty complications and identification of angiographic factors associated with restenosis. Similarly, there has been considerable morphologic interest in distinguishing mechanisms of successful balloon angioplasty from those associated with complications of dilation. Several human necropsy studies (1-17) have indicated that mechanisms of successful balloon angioplasty involve plaque "cracking," "fracturing," "breaking," "tearing," "splitting," "lifting," "separating" and "cleaving."