当前位置： SCI文献检索 > JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY期刊下所有文献 > Arterial remodeling patterns before intervention predict diffuse in-stent restenosis: an intravascular ultrasound study.

Arterial remodeling patterns before intervention predict diffuse in-stent restenosis: an intravascular ultrasound study.

Abstract：

OBJECTIVES:The aim of this retrospective study was to determine the predictors of diffuse in-stent restenosis (ISR) among the lesions causing the first ISR by intravascular ultrasound (IVUS) studies. BACKGROUND:Although some predictors of diffuse ISR have been reported, parameters on IVUS relating to diffuse ISR are not well characterized. METHODS:We classified 52 ISR lesions that had undergone successful stent implantation and led to restenosis into two types--focal and diffuse ISR--using quantitative coronary angiography. Restenosis was defined as > or =50% diameter stenosis, and diffuse ISR as lesion length > or =10 mm at follow-up. The remodeling index (RI) was defined as the vessel area at the target lesion divided by that of averaged reference segments. RESULTS:There were no significant differences in patient, angiographic, and procedural characteristics between the focal (n = 25) and diffuse (n = 27) ISR groups. Baseline RI was significantly greater in the diffuse ISR group (1.03 +/- 0.18 vs. 0.88 +/- 0.24, p = 0.0159). Negative remodeling, defined as RI <0.9, was detected in 60% of the focal ISR group and in only 26% of the diffuse ISR group. By logistic regression analysis, baseline RI was the only independent predictor of diffuse ISR (p = 0.0341). Moreover, volumetric analyses revealed that lesions developing into diffuse ISR had less capacity to compensate for further plaque growth. CONCLUSIONS:Among the first ISR lesions, baseline positive remodeling was the most powerful predictor of diffuse ISR. Measuring pre-interventional arterial remodeling patterns by IVUS may be helpful to stratify lesions at higher risk.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Sahara M,Kirigaya H,Oikawa Y,Yajima J,Ogasawara K,Satoh H,Nagashima K,Hara H,Nakatsu Y,Aizawa T

doi

10.1016/j.jacc.2003.05.009

subject

Has Abstract

pub_date

2003-11-19 00:00:00

pages

1731-8

issue

10

eissn

0735-1097

issn

1558-3597

pii

S0735109703011732

journal_volume

42

pub_type

杂志文章

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