title: Left main coronary in-stent intimal hyperplasia and hemodynamics as detected by contrast-enhanced transesophageal echocardiography.
abstract: METHODS
  In-stent hemodynamics were studied by transesophageal echocardiography (TEE) in a group of 54 patients after left main coronary artery stenting, during a 6-month follow-up. TEE was performed within 24 hours after stenting and at 1- and 3-month follow-up. Pulsed wave and color Doppler signals were enhanced by IV administration of Levovist.
  
  
  RESULTS
  Angiographic immediate success was obtained in all patients. No in-hospital death occurred. Ten patients (18.4%) complained of recurrent angina at the follow-up of 4.8 ± 1.2 months. Both TEE and coronary angiography confirmed in-stent restenosis in all. Thirty-nine patients (68.5%) remained symptoms free. Mean late loss in these patients was 0.69 ± 0.20 mm. A linear significant positive relation between mean late loss values and diastolic coronary velocity (r: 0.89, P < 0.001) was found. After 3- and 6-month follow-up, PDV showed a significant increase in comparison with basal values (0.7 ± 0.3 and 0.6 ± 0.26 vs. 0.32 ± 0.2 cm/sec, P < 0.01). All patients with restenosis showed a significant increase of diastolic coronary velocity in comparison with basal values (2.89 ± 0.25 cm/sec, P < 0.001).
  
  
  CONCLUSIONS
  TEE can predict the development of in-stent intimal hyperplasia in patients with unprotected left main coronary artery stenting.
authors.affiliation: Department of Interventional Cardiology, Ismett/UPMC, Palermo, Italy. baglinir@gmail.com
authors.forename: Roberto
authors.initials: R
authors.lastname: Baglini
authors.forename: Andrea
authors.initials: A
authors.lastname: Amaducci
authors.forename: Giuseppe
authors.initials: G
authors.lastname: D'Ancona
mesh_terms: D003287:Contrast Media; D003326:Coronary Circulation; D023903:Coronary Restenosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology*; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D011134:Polysaccharides; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015607:Stents / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508