Longitudinal plaque redistribution during stent expansion
The purpose of this study was to clarify the 3-dimensional behavior of plaque during coronary stent expansion. Serial intravascular ultrasound (IVUS) studies, preintervention, and poststenting were evaluated in 32 patients treated with a single-balloon expandable tubular stent. External elastic memb...
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Published in | The American journal of cardiology Vol. 86; no. 10; pp. 1069 - 1072 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
Published |
New York, NY
Elsevier Inc
15.11.2000
Elsevier Elsevier Limited |
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Abstract | The purpose of this study was to clarify the 3-dimensional behavior of plaque during coronary stent expansion. Serial intravascular ultrasound (IVUS) studies, preintervention, and poststenting were evaluated in 32 patients treated with a single-balloon expandable tubular stent. External elastic membrane (EEM), lumen, stent, and plaque + media cross-sectional area were measured at 1-mm intervals through the entire stent as well as proximal and distal reference segments 5 mm from the stent edge. Volumetric calculations were based on Simpson’s rule. Overall, the plaque + media volume through the entire lesion did not change during stent expansion (218 ± 51 vs 217 ± 47 mm
3, p = 0.69). However, EEM and lumen volume increased significantly (EEM volume, 391 ± 84 vs 448 ± 87 mm
3 [p <0.0001]; lumen volume, 173 ± 52 vs 231 ± 54 mm
3 [p <0.0001]). The change in lumen volume correlated strongly with the change in EEM volume (r = 0.85, p <0.0001), but poorly with the change in plaque + media volume (r = 0.37, p = 0.03). Plaque + media volume decreased in the midstent zone (59 ± 14 vs 53 ± 11 mm
3, p = 0.0005), and increased in the distal stent zone (40 ± 11 vs 44 ± 9 mm
3, p = 0.003), but did not change in either the proximal stent zone or reference segments. The mechanism of stent expansion is a combination of vessel stretch and plaque redistribution, translating disease accumulation from the midstent zone to the distal stent zone. |
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AbstractList | The purpose of this study was to clarify the 3-dimensional behavior of plaque during coronary stent expansion. Serial intravascular ultrasound (IVUS) studies, preintervention, and poststenting were evaluated in 32 patients treated with a single-balloon expandable tubular stent. External elastic membrane (EEM), lumen, stent, and plaque + media cross-sectional area were measured at 1-mm intervals through the entire stent as well as proximal and distal reference segments 5 mm from the stent edge. Volumetric calculations were based on Simpson's rule. Overall, the plaque + media volume through the entire lesion did not change during stent expansion (218 +/- 51 vs 217 +/- 47 mm3, p = 0.69). However, EEM and lumen volume increased significantly (EEM volume, 391 +/- 84 vs 448 +/- 87 mm3 [p < 0.0001]; lumen volume, 173 +/- 52 vs 231 +/- 54 mm3 [p < 0.0001]). The change in lumen volume correlated strongly with the change in EEM volume (r = 0.85, p < 0.0001), but poorly with the change in plaque + media volume (r = 0.37, p = 0.03). Plaque + media volume decreased in the midstent zone (59 +/- 14 vs 53 +/- 11 mm3, p = 0.0005), and increased in the distal stent zone (40 +/- 11 vs 44 +/- 9 mm3, p = 0.003), but did not change in either the proximal stent zone or reference segments. The mechanism of stent expansion is a combination of vessel stretch and plaque redistribution, translating disease accumulation from the midstent zone to the distal stent zone. The purpose of this study was to clarify the 3-dimensional behavior of plaque during coronary stent expansion. Serial intravascular ultrasound (IVUS) studies, preintervention, and poststenting were evaluated in 32 patients treated with a single-balloon expandable tubular stent. External elastic membrane (EEM), lumen, stent, and plaque + media cross-sectional area were measured at 1-mm intervals through the entire stent as well as proximal and distal reference segments 5 mm from the stent edge. Volumetric calculations were based on Simpson’s rule. Overall, the plaque + media volume through the entire lesion did not change during stent expansion (218 ± 51 vs 217 ± 47 mm 3, p = 0.69). However, EEM and lumen volume increased significantly (EEM volume, 391 ± 84 vs 448 ± 87 mm 3 [p <0.0001]; lumen volume, 173 ± 52 vs 231 ± 54 mm 3 [p <0.0001]). The change in lumen volume correlated strongly with the change in EEM volume (r = 0.85, p <0.0001), but poorly with the change in plaque + media volume (r = 0.37, p = 0.03). Plaque + media volume decreased in the midstent zone (59 ± 14 vs 53 ± 11 mm 3, p = 0.0005), and increased in the distal stent zone (40 ± 11 vs 44 ± 9 mm 3, p = 0.003), but did not change in either the proximal stent zone or reference segments. The mechanism of stent expansion is a combination of vessel stretch and plaque redistribution, translating disease accumulation from the midstent zone to the distal stent zone. The purpose of this study was to clarify the 3-dimensional behavior of plaque during coronary stent expansion. Serial intravascular ultrasound (IVUS) studies, preintervention, and poststenting were evaluated in 32 patients treated with a single-balloon expandable tubular stent. External elastic membrane (EEM), lumen, stent, and plaque + media cross-sectional area were measured at 1-mm intervals through the entire stent as well as proximal and distal reference segments 5 mm from the stent edge. Volumetric calculations were based on Simpson's rule. Overall, the plaque + media volume through the entire lesion did not change during stent expansion (218 +/- 51 vs 217 +/- 47 mm3, p = 0.69). However, EEM and lumen volume increased significantly (EEM volume, 391 +/- 84 vs 448 +/- 87 mm3 [p < 0.0001]; lumen volume, 173 +/- 52 vs 231 +/- 54 mm3 [p < 0.0001]). The change in lumen volume correlated strongly with the change in EEM volume (r = 0.85, p < 0.0001), but poorly with the change in plaque + media volume (r = 0.37, p = 0.03). Plaque + media volume decreased in the midstent zone (59 +/- 14 vs 53 +/- 11 mm3, p = 0.0005), and increased in the distal stent zone (40 +/- 11 vs 44 +/- 9 mm3, p = 0.003), but did not change in either the proximal stent zone or reference segments. The mechanism of stent expansion is a combination of vessel stretch and plaque redistribution, translating disease accumulation from the midstent zone to the distal stent zone. Preintervention and poststenting serial 3-dimensional intravascular ultrasound analyses of 32 de novo lesions treated with a single stent were evaluated. The mechanism of stent expansion is a combination of vessel stretch and plaque redistribution, translating disease accumulation from the midstent zone to the distal stent zone. |
Author | Bonneau, Heidi N Hassan, Ali H.M Okura, Hiroyuki Yock, Paul G Fitzgerald, Peter J Maehara, Akiko Honda, Yasuhiro Takagi, Atsushi |
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Keywords | Sonography Human Endoprosthesis Coronary artery Instrumentation therapy Exploration Endovascular route Stent Vascular remodeling Atherosclerotic plaque Morphological analysis Evolution Tridimensional image Mechanism of action |
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A serial intravascular ultrasound study publication-title: Circulation doi: 10.1161/01.CIR.94.6.1247 contributor: fullname: Hoffmann – volume: 29 start-page: 281A year: 1997 ident: 10.1016/S0002-9149(00)01161-9_BIB6 article-title: Longitudinal redistribution of plaque is an important mechanism for lumen expansion in stenting publication-title: J Am Coll Cardiol contributor: fullname: Honda – volume: 19 start-page: 267 year: 1992 ident: 10.1016/S0002-9149(00)01161-9_BIB7 article-title: Restenosis and the proportional neointimal response to coronary artery injury publication-title: J Am Coll Cardiol doi: 10.1016/0735-1097(92)90476-4 contributor: fullname: Schwartz – volume: 31 start-page: 224 year: 1998 ident: 10.1016/S0002-9149(00)01161-9_BIB8 article-title: In-stent restenosis publication-title: J Am Coll Cardiol doi: 10.1016/S0735-1097(97)00450-6 contributor: fullname: Kornowski |
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Snippet | The purpose of this study was to clarify the 3-dimensional behavior of plaque during coronary stent expansion. Serial intravascular ultrasound (IVUS) studies,... Preintervention and poststenting serial 3-dimensional intravascular ultrasound analyses of 32 de novo lesions treated with a single stent were evaluated. The... |
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SubjectTerms | Angioplasty, Balloon, Coronary - methods Bias Biological and medical sciences Cineradiography Coronary Angiography Coronary Disease - diagnostic imaging Coronary Disease - pathology Coronary Disease - therapy Diseases of the cardiovascular system Elasticity Humans Medical sciences Predictive Value of Tests Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Recurrence Severity of Illness Index Stents Treatment Outcome Tunica Media - diagnostic imaging Tunica Media - pathology Ultrasonography, Interventional - methods |
Title | Longitudinal plaque redistribution during stent expansion |
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