Arterial remodeling patterns before intervention predict diffuse in-stent restenosis
An intravascular ultrasound study
Makoto Sahara, MD*,*,
Hajime Kirigaya, MD*,
Yuji Oikawa, MD*,
Junji Yajima, MD*,
Ken Ogasawara, MD*,
Hiroshi Satoh, MD*,
Kazuyuki Nagashima, MD*,
Hitoshi Hara, MD*,
Yusuke Nakatsu, MD* and
Tadanori Aizawa, MD*
* Department of Internal Medicine, the Cardiovascular Institute Hospital, Tokyo, Japan
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Figure 1 Arterial remodeling patterns. The remodeling index (RI) before intervention was calculated as vessel area (VA) at the target lesion site divided by the averaged VA of reference segments. Patterns of remodeling were classified into three categories: 1) positive remodeling was defined as RI >1.1; 2) intermediate remodeling as RI 0.9 to 1.1; and 3) negative remodeling as RI <0.9. (A) Positive remodeling (RI = 1.30). (B) Negative remodeling (RI = 0.65).
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Figure 2 (A) Negative remodeling (remodeling index [RI] <0.9) was seen in 60% of the focal in-stent restenosis (ISR) lesions and, in contrast, in only 26% of the diffuse ISR lesions. Conversely, positive remodeling (RI >1.1) was seen in only 16% of the focal ISR lesions and in 30% of the diffuse ISR lesions (p = 0.0456 by the chi-square test). (B) The baseline RI in the diffuse ISR group was significantly larger than that in the focal ISR group (1.03 ± 0.18 vs. 0.88 ± 0.24, p = 0.0159). IR = intermediate remodeling; NR = negative remodeling; PR = positive remodeling.
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