title: Impact of preinterventional arterial remodeling on in-stent neointimal hyperplasia and in-stent restenosis after coronary stent implantation.
abstract: BACKGROUND
  Patterns of arterial remodeling during the course of plaque development have been shown to play an important role in both the progression of de novo atherosclerosis and in the restenotic process following coronary intervention. The aim of the present prospective study was to evaluate the effect of pre-interventional arterial remodeling on in-stent neointimal hyperplasia (NIH) and in-stent restenosis (ISR) after stenting.
  
  
  RESULTS
  Pre-interventional arterial remodeling was assessed in 85 native coronary lesions by using intravascular ultrasound (IVUS). The remodeling index (RI) was 1.09+/-0.20 in the positive remodeling (PR)/intermediate remodeling (IR) group and 0.84+/-0.12 in the negative remodeling (NR) group. The plaque plus media cross sectional area (P&M CSA) at pre-intervention and NIH CSA at follow-up in the minimal lumen CSA were significantly larger in the PR/IR group (9.2+/-2.9 mm2 vs 6.2+/-1.8 mm2, 3.3+/-1.2 mm2 vs 1.5+/-0.9 mm2; p = 0.001, p = 0.001, respectively). On 3-dimensional analysis of IVUS images at follow-up, the lumen volume was significantly smaller in the PR/IR group than that in the NR group (62+/-15 mm3 vs 75 +/-20 mm3; p = 0.001), and neointima hyperplasia volume was significantly larger in the PR/IR group than that in the NR group (46+/-15 mm3 vs 26+/-10 mm3; p = 0.001). A significant positive correlation was found between pre-interventional RI and follow-up NIH CSA (r = 0.25, p = 0.022). The incidence of ISR and repeat intervention was significantly higher in the PR/IR group (30.8% vs 18.2%, 28.8% vs 15.2%; p = 0.032, 0.035, respectively).
  
  
  CONCLUSIONS
  Measuring pre-interventional arterial remodeling patterns by IVUS may be helpful to stratify lesions at high-risk of ISR.
authors.affiliation: The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea.
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Hong
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.forename: Dae Woo
authors.initials: DW
authors.lastname: Hyun
authors.forename: Seung Ho
authors.initials: SH
authors.lastname: Hur
authors.forename: Kwon Bae
authors.initials: KB
authors.lastname: Kim
authors.forename: Weon
authors.initials: W
authors.lastname: Kim
authors.forename: Sang Yup
authors.initials: SY
authors.lastname: Lim
authors.forename: Sang Hyun
authors.initials: SH
authors.lastname: Lee
authors.forename: Seo Na
authors.initials: SN
authors.lastname: Hong
authors.forename: Kye Hoon
authors.initials: KH
authors.lastname: Kim
authors.forename: Kyung Ho
authors.initials: KH
authors.lastname: Yun
authors.forename: Dong Goo
authors.initials: DG
authors.lastname: Kang
authors.forename: Yun Sang
authors.initials: YS
authors.lastname: Lee
authors.forename: Hyung Wook
authors.initials: HW
authors.lastname: Park
authors.forename: Ju Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Young Keun
authors.initials: YK
authors.lastname: Ahn
authors.forename: Jeong Gwan
authors.initials: JG
authors.lastname: Cho
authors.forename: Jong Chun
authors.initials: JC
authors.lastname: Park
authors.forename: Jung Chaee
authors.initials: JC
authors.lastname: Kang
mesh_terms: D000368:Aged; D001158:Arteries / Q000000981:diagnostic imaging / Q000473:pathology*; D001161:Arteriosclerosis / Q000473:pathology*; D023903:Coronary Restenosis / Q000209:etiology*; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000209:etiology*; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D012306:Risk; D015607:Stents / Q000009:adverse effects*; D017539:Tunica Intima / Q000473:pathology*; D018084:Ultrasonography, Interventional