title: Intravascular ultrasound findings after excimer laser coronary angioplasty.
abstract: Intravascular ultrasound (IVUS) was used to study 104 lesions in 98 patients after excimer laser coronary angioplasty (ELCA). Lesion site external elastic membrane (EEM) and lumen cross-sectional areas (CSA) were measured; plaque+media (P+M = EEM - lumen) CSA and percentage of cross-sectional narrowing (CSN = P+M CSA/EEM CSA) were calculated; and the results were compared to a reference site. The lumen CSA (2.6 +/- 1.0 mm2) averaged 24% larger than the cross-sectional area of the largest laser catheter used, and 64 lesions (62%) fit the definition of arterial expansion (lesion EEM CSA > reference site EEM CSA). The residual percentage of cross-sectional narrowing averaged 83.8 +/- 8.8%. Dissections were present in 44% of lesions, and were more common in lesions with superficial calcium (59%) than in lesions with only deep calcium (31%) or no calcium (20%, P = 0.0102). Dissections of superficial calcified plaque had an unusual "shattered" or "fragmented" appearance. These findings suggest that excimer laser angioplasty causes forced vessel expansion with dissection, but limited atheroablation.
authors.affiliation: Intravascular Ultrasound Imaging and Cardiac Catheterization Laboratories, Washington Hospital Center, D.C., USA.
authors.forename: G S
authors.initials: GS
authors.lastname: Mintz
authors.forename: J A
authors.initials: JA
authors.lastname: Kovach
authors.forename: A D
authors.initials: AD
authors.lastname: Pichard
authors.forename: K M
authors.initials: KM
authors.lastname: Kent
authors.forename: J J
authors.initials: JJ
authors.lastname: Popma
authors.forename: L F
authors.initials: LF
authors.lastname: Satler
authors.forename: J
authors.initials: J
authors.lastname: Griffin
authors.forename: M B
authors.initials: MB
authors.lastname: Leon
mesh_terms: D017222:Angioplasty, Balloon, Laser-Assisted / Q000009:adverse effects*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018084:Ultrasonography, Interventional