Influence of coronary atherosclerotic remodeling on the mechanism of balloon angioplasty☆,☆☆,★
Section snippets
Study group
Prospective data were collected on 41 consecutive patients with 47 de novo native coronary artery lesions. Each lesion was examined with intracoronary ultrasonography immediately before and after balloon percutaneous transluminal coronary angioplasty (PTCA). Fourteen lesions were studied in the left anterior descending artery, 19 in the circumflex artery, and 14 in the right coronary artery. The indication for angioplasty was angina associated with a coronary artery stenosis of at least 75%.
Baseline findings
At baseline 25 lesions demonstrated compensatory enlargement (group 1), whereas 22 exhibited vessel shrinkage (group 2) (Table I). Before balloon angioplasty was performed, the mean cross-sectional lumen area at the lesion site was similar in each group (group 1, 2.1 ± 1.4 mm2 vs group 2, 2.4 ± 1.3 mm2, p = 0.41). The lumen percent area stenosis determined by intracoronary ultrasonography was also similar in both groups (group 1, 82.4% ± 11.4% vs group 2, 75.2% ± 12.9%, p = 0.05). The vessel
Mechanism of angioplasty
This study is the first to describe that the mode of coronary artery remodeling affects the mechanism of response to balloon angioplasty. Coronary arteries with compensatory enlargement experienced an improvement in the lumen area primarily through a reduction in plaque size, whereas vessel area was minimally affected. Lesions demonstrating vessel shrinkage, on the other hand, achieved their gain by arterial stretch, as shown by an increase in vessel area. Plaque area, however, did not
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Cited by (11)
Impact of pre-interventional arterial remodeling on subsequent vessel behavior after balloon angioplasty: A serial intravascular ultrasound study
2001, Journal of the American College of CardiologyCitation Excerpt :Mintz et al. (18)reported that IVUS-acquired calcium arc within the target lesion was a predictor of negative remodeling. Patterns of pre-intervention arterial remodeling have been shown to affect the mechanism of lumen gain following balloon angioplasty in both peripheral (19)and coronary arteries (20). Pasterkamp et al. (19)reported that the degree of vessel stretch following balloon angioplasty was significantly larger in femoral artery lesions with arterial shrinkage (or NR) compared to the lesions with PR.
Determinants of stent restenosis in chronic coronary occlusions assessed by intracoronary ultrasound
1999, American Journal of CardiologyPlaque characteristics associated with failure of primary balloon angioplasty for intracranial atherosclerotic stenosis: a retrospective study
2024, Journal of NeuroInterventional SurgeryRelation between coronary arterial remodeling and early loss of coronary artery lumen after plain old balloon angioplasty
2003, Japanese Journal of Interventional Cardiology
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From Northwestern University Medical School, Chicago, Ill., and St. Vincent Medical Center, Indianapolis, Ind.
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Reprint requests: Charles J. Davidson, MD, Northwestern Memorial Hospital, 710 North Fairbanks Ct., Olson 4220, Chicago, IL 60611.
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