Abstract
We sought to determine if axial and circumferential distribution of plaque before
stenting determines the axial and circumferential distribution of subsequent intimal
hyperplasia (IH). We studied 22 patients with a single Palmaz-Schatz stent implanted
in a native coronary artery, who underwent intravascular ultrasound (IVUS) imaging
before intervention, after stenting, and at 6-month follow-up. For each lesion, 7
locations were analyzed: proximal and distal reference, proximal and distal edge of
the stent, proximal and distal location within the body of the stent, and the articulation.
Pre- and postintervention and follow-up image slices were precisely aligned and analyzed
for pre- and postintervention plaque area and follow-up IH area and thickness. The
location of maximal IH area was at or adjacent to the location of maximal preintervention
plaque in 17 of 22 of the patients (77%). Similiarly, the circumferential distribution
of IH at follow-up paralleled the eccentricity pattern of the native plaque burden
in 69% (24 of 35 slices). Using multivariant analysis, the strongest predictor of
IH was preintervention plaque area (p = 0.001). IH accumulates axially and circumferentially
preferentially at the site of maximal preintervention plaque.
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Article info
Publication history
Accepted:
June 28,
2000
Received in revised form:
June 28,
2000
Received:
June 6,
2000
Identification
Copyright
© 2000 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.