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CLINICAL STUDY: INTERVENTIONAL CARDIOLOGY

Arterial remodeling influences the development of intimal hyperplasia after stent implantation

^a Cardiovascular Center, Nagoya Daini Red Cross Hospital, Nagoya, Japan

Manuscript received March 13, 2000; revised manuscript received July 11, 2000, accepted September 7, 2000.

Reprint requests and correspondence: Dr. Akihiro Endo, First Department of Internal Medicine, Tottori University, Faculty of Medicine, 36-1 Nishimachi, Yonago 683-8504, Japan
akjendou-circ{at}umin.ac.jp

OBJECTIVES

We examined whether preinterventional arterial remodeling influenced the interventional results after stenting.

BACKGROUND

Arterial remodeling is seen in atherosclerotic lesions, and it may play an important role in the early stage of atherosclerosis.

METHODS

We examined 113 lesions that underwent elective stenting using tubular slotted stents under intravascular ultrasound guidance. The lesions were divided into three groups—adequate, intermediate and inadequate remodeling group—according to preinterventional arterial remodeling. The patients were subjected to coronary angiography and intravascular ultrasound evaluation on average 6.4 months after stenting.

RESULTS

At baseline and immediately after stenting, there were no differences in quantitative angiographic analysis among remodeling groups. However, the plaque cross-sectional area (CSA) in the minimal lumen CSA at preintervention and intimal hyperplasia CSA at follow-up were significantly larger in the adequate remodeling group than in the inadequate remodeling group. The restenosis rate of stenting for the lesions with inadequate arterial remodeling was very low (9.4%). A significant positive correlation was found between preinterventional plaque CSA and intimal hyperplasia CSA at follow-up (r = 0.47, p < 0.0001). Moreover, remodeling index significantly correlated with relative intimal hyperplasia CSA (r = 0.28, p < 0.01).

CONCLUSIONS

Preinterventional arterial remodeling influenced the development of intimal hyperplasia after stenting.

Abbreviations and Acronyms   CSA = cross-sectional area   EEM = external elastic membrane   IVUS = intravascular ultrasound   QCA = quantitative coronary angiography

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