Intravascular ultrasonic comparisons of mechanisms of vasodilatation of cutting balloon angioplasty versus conventional balloon angioplasty.
Intimal hyperplasia after balloon dilatation may be related to the severity of vascular injury, and cutting balloon angioplasty (CBA) may reduce vascular injury. The present study investigated the mechanism of vasodilation by CBA. Intravascular ultrasound examination was performed before and after intervention in 40 lesions treated with CBA and in 25 lesions treated with conventional balloon angioplasty. Intravascular ultrasound measurements included the vessel area, luminal area, and plaque area. Vessel expansion was evaluated as the ratio of the postprocedural vessel area to that before intervention. The vessel area was 13.9 +/- 3.2 and 14.8 +/- 3.2 mm(2) after CBA versus conventional angioplasty, respectively, whereas the luminal area was 5.5 +/- 1.2 versus 5.7 +/- 1.2 mm(2) and the plaque area was 8.5 +/- 2.7 versus 9.1 +/- 2.2 mm(2), respectively. The vessel area was smaller and the plaque area significantly smaller after CBA. Vessel expansion accounted for 45% of luminal enlargement, and plaque compression or shift accounted for 55% after CBA. After conventional angioplasty, vessel expansion accounted for 67%, and plaque compression or shift for 33% of luminal enlargement. The vessel expansion ratio was significantly smaller after CBA than after conventional angioplasty (1.05 vs 1.22, p <0.05). These findings suggest that the predominant mechanism of dilatation after CBA is plaque compression or shift rather than vessel expansion, unlike conventional angioplasty.
Hara
Hisao
H
Third Department of Internal Medicine, Ohashi Hospital, Toho University School of Medicine, Tokyo, Japan. harahisa@d1.dion.ne.jp
Nakamura
Masato
M
Asahara
Toshiyuki
T
Nishida
Takahiro
T
Yamaguchi
Tetsu
T
D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional; D014664:Vasodilation