Effect of preinterventional arterial remodeling on intimal hyperplasia after implantation of a polymer-based paclitaxel-eluting stent: angiographic and IVUS study.
BACKGROUND
The aim of this study was to evaluate the effect of preinterventional arterial remodeling on in-stent intimal hyperplasia (IH) after the implantation of a polymer-based paclitaxel-eluting stent.


METHODS
The study population consisted of 55 patients (61 lesions) with a de novo lesion treated with a paclitaxel-eluting stent. The lesions were divided into two groups, positive or intermediate (PR/IR), and negative remodeling (NR) groups, according to the preinterventional arterial remodeling. Angiographic and IVUS examinations were performed preintervention, postintervention and at 9 months of follow-up.


RESULTS
The remodeling index (RI) was 1.19+/-0.16 in the PR/IR group and 0.81+/-0.10 in the NR group. At follow-up, the late loss was significantly larger in the PR/IR group than in the IR group. (0.65+/-0.58 mm vs. 0.29+/-0.5 mm, p=0.017). The external elastic membrane cross-sectional area (CSA) (18.68+/-5.39 vs. 12.87+/-3.72 mm(2), p=0.000), plaque CSA (16.99+/-4.04 vs. 10.34+/-3.45 Mm(2), p=0.000) and plaque index (85.84+/-5.02 vs. 81.80+/-7.26%, p=0.048) during the preintervention period and IH volume during the follow-up were significantly larger in the PR/IR group than in the NR group (17.98+/-16.7 mm(3) vs. 4.59+/-12.4 mm(3); p<0.001). Further, the percentage of the change in the IH was also larger in the PR/IR group than in the NR group (13.49+/-11.78% vs. 4.12+/-10.76%; p=0.002). A significant positive correlation was found between the preinterventional RI and follow-up IH CSA (r=0.406, p=0.001).


CONCLUSIONS
The preinterventional arterial remodeling influenced the development of the IH after the implantation of the polymer-based paclitaxel-eluting stent which had a greater effect on reducing the IH accumulation in the lesions with preinterventional negative remodeling characteristics.
Kang
Woong Chol
WC
Division of Cardiology, Gil Medical Center, Gachon University of Medicine and Science, 1198 Kuwol-dong, Namdong-gu, Incheon 405-760, Republic of Korea.
Oh
Kyu Jin
KJ
Han
Seung Hwan
SH
Ahn
Tae Hoon
TH
Chung
Wook-Jin
WJ
Shin
Mi-Seung
MS
Koh
Kwang Kon
KK
Choi
In Suck
IS
Shin
Eak Kyun
EK
D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006965:Hyperplasia; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000494:pharmacology*; D011300:Preoperative Care / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D015607:Stents; D017539:Tunica Intima / Q000000981:diagnostic imaging; D018084:Ultrasonography, Interventional / Q000379:methods*
D017239:Paclitaxel