Rupture of the arterial wall causes deflection in pressure time course during ex vivo balloon angioplasty

A relation between restenosis and arterial lesions resulting from balloon angioplasty has been suggested in literature. Nevertheless, it is unclear to what extent angioplasty‐induced arterial wall lesions contribute to the occurrence of restenosis. One problem is that arterial ruptures cannot be detected during balloon inflation. This study describes a method to detect ruptures in the arterial wall, based on deflections observable in the development of the balloonpressure. We performed ex vivo angioplasty with constant strain rate on 28 human femoral artery segments, showing deflections in 21 cases. In 20 cases wall rupture was confirmed histologically. From seven cases not showing deflections, four showed intact wall at microscopy. These figures result in a selectivity of the proposed method of 87 ± 7% and a predictive value of the positive test of 95 ± 5%. We conclude that this method can enhance detection of arterial rupture during ex vivo angioplasty and may become important clinically. Cathet. Cardiovasc. Diagn. 42:92–101, 1997. © 1997 Wiley‐Liss, Inc.