This Article Abstract Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Radke, P. W. Articles by Hanrath, P. Search for Related Content PubMed PubMed Citation Articles by Radke, P. W. Articles by Hanrath, P.

Mechanisms of acute lumen gain and recurrent restenosis after rotational atherectomy of diffuse in-stent restenosis

A quantitative angiographic and intravascular ultrasound study

^a Medical Clinic I, RWTH University Hospital, Aachen, Germany

View larger version (23K): [in a new window]   Figure 1 Comparison of minimal lumen diameter measurements obtained by intravascular ultrasound (IVUS) and quantitative coronary angiography (QCA) before intervention (A), after rotational atherectomy (B) and after percutaneous transluminal coronary angioplasty (PTCA) (C) using the Bland-Altman method. The individual differences between pairs of measurements (on the y-axis) are plotted against the mean value of IVUS and QCA (on the x-axis). CI = confidence interval.

View larger version (85K): [in a new window]   Figure 2 Relation between in-stent neointima distribution and focal plaque ablation. Due to inhomogeneous plaque distribution and focal neointima accumulation (1A, 1B) the minimal lumen diameter before rotablation ranges between 0.9 mm (1D) and 2.4 mm (1C) by intravascular ultrasound. Rotational atherectomy (burr size 2.38 mm) does not induce further plaque ablation in those parts of the stent with a larger lumen (2A, 2C), even though there is significant plaque burden. Focal plaque ablation (2B) leads to an increase in the minimal lumen diameter and cross-sectional area as shown by intravascular ultrasound (2D); however, the final burr/lumen ratio >1 indicates acute neointimal recoil.