Distensibility of the ascending aorta, measured non-invasively, was compared with values obtained by invasive techniques in 46 males (30 patients with coronary artery disease and 16 age-matched normal subjects). Aortic diameters were measured at a level 3 cm above the aortic valve using both echocardiographic and angiographic techniques. Aortic distensibility was calculated from the aortic diameters and aortic pressure or brachial artery pressure using the formula: 2 x (change in aortic diameter)/(diastolic aortic diameter) x (change in aortic pressure). Distensibility of the ascending aorta determined non-invasively was closely related to that obtained by direct measurements (r = 0.949, P less than 0.001). Patients with coronary artery disease had similar pressures, but markedly lower distensibility than normal subjects, as shown by both invasive and non-invasive techniques. The results indicate that aortic distensibility in patients with coronary artery disease can be obtained non-invasively with a high degree of accuracy.

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A new type of steerable guiding catheter is described for use in percutaneous transluminal coronary angioplasty (PTCA). It is simple to use and externally steerable. The catheter incorporates a steering system by means of which the catheter tip can be made to assume the form of either a right or left Judkins catheter or to be fixed in any intermediate configuration, entirely through external manipulation. We used this new guiding catheter to perform PTCA on 15 patients. Single lesions were found in the left anterior descending branch in seven patients, in the right coronary artery in four, and in the circumflex artery in two, whereas stenosis of a coronary bypass graft was found in two patients. Angioplasty was successful in all cases. There were no complications, during either the procedure or the postoperative hospitalization. The steerable guiding catheter described here may prove useful for PTCA in cases where a conventional catheter cannot be placed accurately or in cases with multi-vessel coronary disease.