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Effect of rotational atherectomy in noncalcified atherosclerotic plaque: a volumetric intravascular ultrasound study.

Abstract：

OBJECTIVES:This study used pre-rotational and post-rotational atherectomy volumetric intravascular ultrasound analysis to determine whether rotational atherectomy causes ablation of non-calcified atherosclerotic plaque. BACKGROUND:Rotational atherectomy is currently the preferred treatment for heavily calcified coronary lesions. However, the mechanism of lumen enlargement in noncalcified lesions has not been studied in detail. Intravascular ultrasound allows detailed, cross-sectional imaging of the coronary arteries in vivo. The normal coronary artery wall, the major components of the atherosclerotic plaque and the quantitative changes in vessel, lumen and plaque cross-sectional areas and volumes that occur as a result of the atherosclerotic disease process and during transcatheter therapy can be studied in a manner otherwise not possible. METHODS:Eighteen noncalcified native vessel lesions in 18 patients were imaged before and after rotational atherectomy using intravascular ultrasound systems incorporating motorized transducer pullback through a stationary imaging sheath. External elastic membrane, lumen and plaque plus media cross-sectional areas were measured every 1 mm of lesion length (for a total of 10 image slices), and external elastic membrane, lumen and plaque plus media volumes were calculated using Simpson's rule. RESULTS:After rotational atherectomy, the minimal lumen cross-sectional area increased from 1.37 +/- 0.50 to 2.99 +/- 0.60 mm2 (mean value +/- 1 SD, p < 0.0001). Lumen volume increased from 23.2 +/- 9.0 to 38.0 +/- 8.0 mm3 (p < 0.0001) as a result of a decrease in plaque plus media volume (from 102.2 +/- 50.9 to 85.8 +/- 47.7 mm3, p < 0.0001), with no change in total vessel (external elastic membrane) volume (125.3 +/- 54.2 to 123.8 +/- 52.9 mm3, p = 0.119). CONCLUSIONS:Rotational atherectomy effectively ablates noncalcified plaque in non-calcium-containing lesions.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Dussaillant GR,Mintz GS,Pichard AD,Kent KM,Satler LF,Popma JJ,Leon MB

doi

10.1016/s0735-1097(96)00255-0

subject

Has Abstract

pub_date

1996-10-01 00:00:00

pages

856-60

issue

4

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(96)00255-0

journal_volume

28

pub_type

杂志文章

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