title: Effect of preintervention plaque burden on subsequent intimal hyperplasia in stented coronary artery lesions.
abstract: We sought to determine if axial and circumferential distribution of plaque before stenting determines the axial and circumferential distribution of subsequent intimal hyperplasia (IH). We studied 22 patients with a single Palmaz-Schatz stent implanted in a native coronary artery, who underwent intravascular ultrasound (IVUS) imaging before intervention, after stenting, and at 6-month follow-up. For each lesion, 7 locations were analyzed: proximal and distal reference, proximal and distal edge of the stent, proximal and distal location within the body of the stent, and the articulation. Pre- and postintervention and follow-up image slices were precisely aligned and analyzed for pre- and postintervention plaque area and follow-up IH area and thickness. The location of maximal IH area was at or adjacent to the location of maximal preintervention plaque in 17 of 22 of the patients (77%). Similiarly, the circumferential distribution of IH at follow-up paralleled the eccentricity pattern of the native plaque burden in 69% (24 of 35 slices). Using multivariant analysis, the strongest predictor of IH was preintervention plaque area (p = 0.001). IH accumulates axially and circumferentially preferentially at the site of maximal preintervention plaque.
authors: Intravascular Ultrasound Imaging and Cardiac Catheterization Laboratories, Washington Hospital Center, DC 20010, USA.
authors: A
authors: A
authors: Shiran
authors: N J
authors: NJ
authors: Weissman
authors: B
authors: B
authors: Leiboff
authors: K M
authors: KM
authors: Kent
authors: A
authors: A
authors: Pichard
authors: L F
authors: LF
authors: Satler
authors: H
authors: H
authors: Wu
authors: M B
authors: MB
authors: Leon
authors: G S
authors: GS
authors: Mintz
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006965:Hyperplasia; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015607:Stents; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology*; D018084:Ultrasonography, Interventional