Abstract
Objectives: We tested the hypothesis that lumen diameter loss within 1 h after percutaneous transluminal coronary angioplasty is related to plaque volume parameters. Background: Early lumen diameter loss after coronary balloon angioplasty may predict restenosis and may paradoxically decrease late lumen diameter loss. Viscous properties of the vessel wall, as would be determined by tissue volume and composition, may be involved in early lumen diameter loss. Methods: Early lumen diameter loss was measured with quantitative coronary angiography as the loss in lesion lumen diameter (significant loss 0.4 mm) occurring between 5 min and a median of 40 min after successful coronary balloon angioplasty in 68 patients. Thirty-nine patients were evaluated with intravascular ultrasound at the narrowest lumen cross-section of the dilated lesion, 29 patients formed a control group without intravascular ultrasound imaging. We tested the relation between intravascular ultrasound parameters and early lumen diameter loss. Results: Early lumen diameter loss of ≥0.4 mm was present in eight patients (12%), decreasing lumen diameter from 2.26 ± 0.36 mm to 1.73 ± 0.43 mm. There was no difference in the frequency of early lumen diameter loss between the groups with or without intravascular ultrasound imaging. Univariate intravascular ultrasound determinants of early lumen diameter loss were media bounded area (p = 0.01), maximal plaque thickness (p = 0.02), eccentricity index (p = 0.03) and the presence of hard lesions (p = 0.02). Conclusion: Early lumen diameter loss in the first hour after successful coronary balloon angioplasty occurs in a small proportion of patients. It is related to hard lesion type, maximal plaque thickness and eccentricity index, favoring a role for viscous plaque properties in early lumen diameter loss.
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Braden GA, Herrington DM, Downes TR, Kutcher MA, Little WC. Qualitative and quantitative contrasts in the mechanisms of lumen enlargement by coronary balloon angioplasty and directional atherectomy. J Am Coll Cardiol 1994; 23: 40-80.
Baptista J, DiMario C, Ozaki Y, et al. Impact of plaque morphology and composition on the mechanism of lumen enlargement using intracoronary ultrasound and qualitative angiography after balloon angioplasty. Am J Cardiol 1996; 77: 115-121.
Marsico F, Kubica J, De Servi S, et al. Influence of plaque morphology on the mechanism of luminal enlargement after directional coronary atherectomy and balloon angioplasty. Br Heart J 1995; 74: 134-139.
Mintz GS, Pichard AD, Kent KM, Satler LF, Popma JJ, Leon MB. Axial plaque distribution as a mechanism of percutaneous transluminal coronary angioplasty. Am J Cardiol 1996; 77: 427-430.
Rensing BJ, Hermans WRM, Beatt KJ, et al. Quantitative angiographic assessment of elastic recoil after percutaneous transluminal coronary angioplasty. Am J Cardiol 1990; 66: 1039-1044.
Hermans WRM, Rensing BJ, Strauss BH, Serruys PW. Methodological problems related to the quantitative assessment of stretch, elastic recoil, and balloon-artery ratio. Cathet Cardiov Diagn 1992; 25: 174-185.
Rozenman Y, Gilon D, Welber S, Sapoznikow D, Gotsman MS. Clinical and angiographic predictors of immediate recoil after successful coronary angioplasty and relation to late restenosis. Am J Cardiol 1993; 72: 1020-1025.
Ardissino D, Di Somma S, Kubica J, et al. Influence of elastic recoil on restenosis after successful coronary angioplasty in unstable angina pectoris. Am J Cardiol 1993; 71: 659-663.
Haude M, Erbel R, Issa H, Meyer J. Quantitative analysis of elastic recoil after balloon angioplasty and after intra-coronary implantation of balloon-expandable Palmatz-schatz stents. J Am Coll Cardiol 1993; 21: 26-34.
Fischell TA, Derby G, Tse TM, Stadius ML. Coronary artery vasoconstriction routinely occurs after percutaneous transluminal angioplasty. Circulation. 1988; 78; 1323-1334.
El-Tamimi H, Davies G.J., Hackett D, Sritara P, Bertrand O, Crea F, Maseri A. Abnormal vasomotor changes early after coronary angioplasty. Circulation 1991; 84: 1198-1202.
Preisack MB, Athanasiadis A, Voelker W, Karsch KR. Reliability of quantitative coronary angiography of the target lesion immediately and 1 day after coronary balloon and excimer laser angioplasty. J Am Coll Cardiol 1993; 21: 876-884.
Rodriguez A, Santaera O, Larribeau M, Sosa MI, Palacios IF. Early decrease in minimal luminal diameter after successful percutaneous transluminal coronary angioplasty predicts late restenosis. Am J Cardiol 1993; 71: 1391-1395.
Rodriguez AE, Palacios IF, Fernandez MA, Larribau M, Giraudo M, Ambrose JA. Time course and mechanism of early luminal diameter loss after percutaneous transluminal coronary angioplasty. Am J Cardiol 1995; 75: 1131-1134.
den Heijer P, van Dijk RB, Hillege HL, Pentinga ML, Serruys PW, Lie KI. Serial angioscopic and angiographic observations during the first hour after successful coronary angioplasty: a preamble to a multicenter trial addressing angioscopic markers for restenosis. Am Heart J 1994; 128: 656-663.
Gregorini L, Fajadet J, Robert G, Cassagneau B, Bernis M, Marco J. Coronary vasoconstriction after percutaneous transluminal coronary angioplasty is attenuated by antiadrenergic agents. Circulation 1994; 90: 895-907.
Indolfi C, Piscione F, Rapacciuolo A, et al. Coronary artery vasoconstriction after successful single angioplasty of the left anterior descending artery. Am Heart J 1994; 128: 858-864.
Anderson HV, Kirkeeide RL, Krishnaswami A, et al. Cyclic flow variations after coronary angioplasty in humans: clinical and angiographic characteristics and elimination with 7E3 monoclonal antiplatelet antibody. J Am Coll Cardiol 1994; 23: 1031-1037.
Lee RT, Kamm RD. Vascular mechanics for the cardiologist. J Am Coll Cardiol 1994; 23: 1289-1295.
Minns RJ, Soden PD, Jackson DS. The role of fibrous components and ground substance in the mechanical properties of biological tissues: a preliminary investigation. J Biomechanics 1973; 6: 153-165.
Ryan TJ, Faxon DP, Gunnar RM, et al. Guidelines for percutaneous transluminal coronary angioplasty: A report of the American College of Cardiology/American Heart Association task force on assessment of diagnostic and therapeutic coronary angioplasty. J Am Coll Cardiol 1988; 12: 529-545.
Mancini GB, Simon SB, McGillem MJ, LeFree MT, Friedman HZ, Vogel RA. Automated quantitative coronary angiography: morphologic and physiologic validation in vivo of a rapid digital angiographic method. Circulation 1987; 75: 452-460.
Gussenhoven EJ, Essed CE, Lancée CT, Mastik F, et al. Arterial wall characteristics determined by intravascular ultrasound imaging: an in vitro study. J Am Coll Cardiol 1989; 14: 947-952.
Wenguang L, Gussenhoven WJ, Zhong Y, et al. Validation of quantitative analysis of intravascular ultrasound images. Int J Card Imaging 1991; 6: 247-253.
Peters RJG, Kok WEM, Di Mario C, et al. Prediction of restenosis after coronary balloon angioplasty. Circulation 1997; 95: 2254-2261.
Waller BF, Pinkerton CA, Orr CM, Slack JD, Van Tassel JW, Peters T. Restenosis 1 to 24 months after clinically successful coronary balloon angioplasty: a necropsy study of 20 patients J Am Coll Cardiol 1991; 17: 58B-70B.
Foley DP, Deckers J, van den Bos AA, et al. Usefulness of repeat coronary angiography 24 hours after successful balloon angioplasty to evaluate early luminal deterioration and facilitate quantitative analysis. Am J Cardiol 1993; 72: 3141-3147.
Hanet C, Michel X, Schroeder E, Wijns W. Absence of detectable delayed elastic recoil 24 hours after percutaneous transluminal coronary angioplasty. AM J Cardiol 1993; 71: 1433-1436.
Foley DP, Melkert R, Serruys PW, on behalf of the CARPORT, MERCATOR, MARCATOR and PARK investigators. Influence of coronary vessel size on renarrowing process and late angiographic outcome after successful balloon angioplasty. Circulation 1994; 90: 1239-1251.
Moreno PR, Fallon JT, Bernardi VH, et al. Histopathology of coronary lesions with early loss of minimal luminal diameter after successful percutaneous coronary angioplasty: is thrombus a significant contributor? Am Heart J 1998; 136: 804-811.
Mintz GS, Popma JJ, Hong MK, et al. Intravascular ultrasound to discern device-specific effects and mechanisms of restenosis. Am J Cardiol 1996; 78(suppl 3A): 18-22.
The GUIDE trial investigators. IVUS-determined predictors of restenosis in PTCA and DCA: final report from the GUIDE trial, Phase II (abstact). J Am Coll Cardiol 1996; 27: 156A.
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Kok, W.E., Peters, R.J., Pasterkamp, G. et al. Early lumen diameter loss after percutaneous transluminal coronary angioplasty is related to coronary plaque burden: A role for viscous plaque properties in early lumen diameter loss. Int J Cardiovasc Imaging 17, 111–121 (2001). https://doi.org/10.1023/A:1010615503672
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DOI: https://doi.org/10.1023/A:1010615503672