title: Highly localized arterial remodeling in patients with coronary atherosclerosis: an intravascular ultrasound study.
abstract: BACKGROUND
  Preservation of luminal area and symmetry in the presence of irregular plaques necessitates local expansion of the artery wall.
  
  
  RESULTS
  Cross-sectional dimensions of coronary arteries in 65 patients were measured with the use of intravascular ultrasound. A total of 104 arterial segments were studied, of which 88 had atherosclerosis; 16 served as nonatherosclerotic control segments. Three features of atherosclerotic arterial segments were classified: (1) plaque formation, (2) lumen shape, and (3) shape of arterial external elastic lamina. With our intravascular ultrasound-based three-level classification system, we identified three patterns that accounted for 89% of all atherosclerotic arterial segments: (1) concentric plaque with a circular lumen and a circular external elastic lamina (n= 17), (2) eccentric plaque with a circular lumen and an oval external elastic lamina (n=35), and (3) eccentric plaque with an oval lumen and a circular external elastic lamina (n=26). A circular lumen was preserved in 66% of all atherosclerotic arterial segments. Arterial segments with a circular lumen in the presence of an eccentric plaque had a significantly larger lumen area than the other two main groups (P<.05).
  
  
  CONCLUSIONS
  With our intravascular ultrasound-based classification, we provided information regarding the local remodeling response in the coronary artery wall. In a majority of cases, a circular lumen is maintained. Failure of this highly localized response to be operative may contribute to the development of stenotic lesions at a specific site in the artery.
authors.affiliation: Department of Cardiology, Huddinge University Hospital, Stockholm, Sweden.
authors.forename: H
authors.initials: H
authors.lastname: Berglund
authors.forename: H
authors.initials: H
authors.lastname: Luo
authors.forename: T
authors.initials: T
authors.lastname: Nishioka
authors.forename: M C
authors.initials: MC
authors.lastname: Fishbein
authors.forename: N L
authors.initials: NL
authors.lastname: Eigler
authors.forename: S W
authors.initials: SW
authors.lastname: Tabak
authors.forename: R J
authors.initials: RJ
authors.lastname: Siegel
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018084:Ultrasonography, Interventional