Predictors of restenosis: a morphometric and quantitative evaluation by intravascular ultrasound

Jain, Suresh P., Jain, Ashit, Collins, Tyrone J., Ramee, Stephen R. and White, Christopher J. (1994) Predictors of restenosis: a morphometric and quantitative evaluation by intravascular ultrasound. American Heart Journal, 128 4: 664-673. doi:10.1016/0002-8703(94)90262-3

Author Jain, Suresh P.
Jain, Ashit
Collins, Tyrone J.
Ramee, Stephen R.
White, Christopher J.
Title Predictors of restenosis: a morphometric and quantitative evaluation by intravascular ultrasound
Journal name American Heart Journal   Check publisher's open access policy
ISSN 0002-8703
Publication date 1994-10
Sub-type Article (original research)
DOI 10.1016/0002-8703(94)90262-3
Volume 128
Issue 4
Start page 664
End page 673
Total pages 10
Place of publication Philadelphia, PA, United States
Publisher Mosby
Language eng
Abstract Despite advances in catheter-based interventional techniques, restenosis remains a major complication of angioplasty. Recently, intravascular ultrasound imaging (IVUS) has provided new insight into plaque composition and geometric distribution inside the vessel. To investigate if : : IVUS-defined parameters can predict restenosis in patients after coronary angioplasty, we performed IVUS in 33 patients (33 lesions) after balloon angioplasty (n= 25) or directional : atherectomy (n = 8). Qualitative analysis included assessment of plaque composition, plaque eccentricity, plaque fracture, and presence of dissection. In addition, minimal luminal diameter, percent diameter stenosis, percent area stenosis, plaque burden, and elastic recoil were quantitatively analyzed. Follow-up data were obtained 1, 2, and 6 months after angioplasty and were available for 30 patients. Angiographic restenosis occurred in 11 patients (group 1), and no restenosis occurred in 19 patients (group 2) by clinical (n=10) or angiographic (n = 9) assessment. Plaque fracture was noted in 30% of group 1 patients and 74% of group 2 patients (p = 0.04). Major dissections were more frequent in group I than in group II (78% vs 10%, p = 0.009). Of the quantitative parameters analyzed, plaque burden was significantly higher in group 1 than in group 2 (0.50 ± 0.05 vs 0.34 ± 0.05, p = 0.0001). In 78% of the patients with plaque burden of >0.40, restenosis developed. Thus, of the various parameters analyzed, the absence of plaque fracture, the existence of a major dissection, and greater plaque burden were associated with increased incidence of restenosis. Our results indicate that IVUS can identify a : subset of patients in whom restenosis is likely to develop. lnformation about the morphologic. features of the atheroma and its composition may be used to modify the interventional strategy and thus optimize lumen size and possibly reduce the chance of restenosis.
Keyword Luminal coronary angioplasty
Balloon angioplasty
Artery disease
Intracoronary ultrasound
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ
Additional Notes Clinical investigation

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Created: Mon, 14 Mar 2011, 10:23:59 EST