Mechanisms of acute lumen gain following cutting balloon angioplasty in calcified and noncalcified lesions: an intravascular ultrasound study.
Several studies have shown that mechanisms for lumen enlargement following conventional balloon angioplasty (BA) consist of plaque reduction and vessel expansion. To assess the mechanisms of lumen enlargement after Cutting Balloon (CB) angioplasty, intravascular ultrasound images were analyzed in 180 lesions (89 CB and 91 BA). External elastic membrane (EEM) cross-sectional area (CSA), lumen CSA, and plaque plus media (P+M) CSA were measured before and after angioplasty. In the CB group, lower balloon pressure was utilized (P < 0.0001). DeltaP+M CSA was significantly larger (P = 0.02) and deltalumen CSA showed a trend toward being larger (P = 0.07) compared to BA group. For noncalcified lesions, CB resulted in a larger deltaP+M CSA (P < 0.05) and a smaller deltaEEM CSA (P = 0.10) than BA. For calcified lesions, deltalumen CSA was significantly larger in the CB group (P < 0.05) without significant differences in deltaEEM CSA and deltaP+M CSA. Dissections complicated with calcified lesions were associated with larger deltalumen CSA for the CB group. In conclusion, for noncalcified lesions, CB achieves similar luminal dimensions with larger plaque reduction and less vessel expansion compared to BA. On the other hand, for calcified lesions, the CB achieves larger lumen gain, especially in lesions with evidence of dissections.
Okura
Hiroyuki
H
Center for Research in Cardiovascular Interventions, Stanford University Medical Center, Stanford, California 94305, USA. peter_fitzgerald@cvmed.stanford.edu
Hayase
Motoya
M
Shimodozono
Shinichi
S
Kobayashi
Toru
T
Sano
Kazuya
K
Matsushita
Toyoaki
T
Kondo
Taizo
T
Kijima
Mikihiko
M
Nishikawa
Hideo
H
Kurogane
Hiroyuki
H
Aizawa
Tadanori
T
Hosokawa
Hiroaki
H
Suzuki
Takahiko
T
Yamaguchi
Tetsu
T
Bonneau
Heidi N
HN
Yock
Paul G
PG
Fitzgerald
Peter J
PJ
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D004548:Elasticity; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018084:Ultrasonography, Interventional