A novel mechanism explaining early lumen loss following balloon angioplasty for the treatment of in-stent restenosis

Albertal, Mariano; Abizaid, Alexandre; Muñoz, Juan Simon; Mintz, Gary S.; Abizaid, Andréa S.; Feres, Fausto; Centemero, Marinella; Staico, Rodolfo; Mattos, Luiz Alberto; Graebin, Roselei; Sousa, Amanda Guerra de Moraes Rego; Sousa, J. Eduardo

doi:10.1016/j.amjcard.2004.11.028

Cited by 9 publications

(7 citation statements)

References 6 publications

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“…Although the exact mechanism remains unclear, given that early lumen loss represents as much as 40% of late loss [18], cell-poor tissue may cause less decompression, resulting in less early (and late) lumen loss. Furthermore, recurrent neointima growth (by injury) may also be reduced in cell-poor tissue (hetero group).…”

Section: Acute and Long-term Outcomes Associated With Oct Morphologymentioning

confidence: 97%

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Simple balloon dilation for drug-eluting in-stent restenosis: An optical coherent tomography analysis

Arikawa¹,

Yamaguchi²,

Takaoka³

et al. 2015

Cardiovascular Revascularization Medicine

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Section: Acute and Long-term Outcomes Associated With Oct Morphologymentioning

confidence: 97%

“…Early lumen loss was also detected by IVUS, and tissue decompression (after compression) was suggested as the main mechanisms [18].…”

Section: Acute and Long-term Outcomes Associated With Oct Morphologymentioning

confidence: 99%

Simple balloon dilation for drug-eluting in-stent restenosis: An optical coherent tomography analysis

Arikawa¹,

Yamaguchi²,

Takaoka³

et al. 2015

Cardiovascular Revascularization Medicine

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“…Moreover, balloon protrusion outside the stent 11) may have an additional effect, especially at the distal edge. However, recent studies reported both lumen loss 4,6) and lumen gain 7,12) after coronary stenting. Follow-up changes: Unlike the contribution of plaque shift at the postintervention level, it did not correlate significantly with either follow-up ∆PMV or ∆VV and consequently it did not correlate significantly with ∆LV.…”

Section: Discussionmentioning

confidence: 99%

<b>Poststenting Axial Redistribution of Atherosclerotic Plaque Into the Reference Segments and Lumen Reduction at the Stent Edge</b>

et al. 2006

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SUMMARYLumen enlargement during coronary stenting results from vessel expansion and axial redistribution of atheromatous plaque along the stented segment and proximal and distal reference segments. Plaque burden predicts stenosis at the stent edge. The aim of this study was to investigate the fate of shifted plaque with special reference to whether or not plaque shift (PSh) correlates with late lumen reduction. This is a prospective study conducted on 54 consecutive patients who underwent bare metal stenting. In all stent edges (108 edges), PSh volume was measured as postintervention plaque-media volume (PMV) minus preintervention PMV. Changes in lumen volume (∆LV), vessel volume (∆VV), and PMV (∆PMV) were measured by serial intravascular ultrasound (IVUS) examination. After stenting, PSh was detected in 81.5% of proximal edges versus 72.2% of distal edges (P = 0.36). It correlated significantly with ∆VV (r = 0.34, P = 0.002), and inversely with ∆LV (r = 0.32, P = 0.003). However, at 6-month follow-up, it did not correlate with ∆LV (r = −0.03, P = 0.8), ∆VV (r = 0.1, P = 0.6), or ∆PMV (r = 0.1, P = 0.4). Furthermore, ∆LV correlated more strongly with ∆VV (r = 0.62, P < 0.00001) than with ∆PMV (r = − 0.39, P = 0.001). By multivariate analysis, PSh area was an independent predictor of the postintervention change in lumen area (partial eta squared 0.21, P = 0.01), but not the follow-up change. Two patients (3.7%) developed proximal edge stenosis with no evident PSh after stenting. Thus, axial redistribution of atheromatous plaque into the reference segments was frequently encountered after stenting. Although PSh correlated with the immediate reduction in stent edge lumen volume, it did not correlate with the late lumen reduction. (Int Heart J 2006; 47: 159-171)

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“…En un análisis volumétrico realizado con IVUS durante el tratamiento de la restenosis intrastent con balón, se observó que inmediatamente después de la angioplastia el volumen de tejido intrastent se reduce en un 50% y 30 minutos después aumenta un 32% 102 . Estudios recientes han demostrado un claro benefi cio del balón con droga versus el balón convencional en el tratamiento de la restenosis intrastent en el sector FP, aunque los resultados parecen ser menos favorables que en las lesiones de novo 103,104,105 La tasa de restenosis intrastent, en varios trabajos randomizados con lesiones de longitud media < 10 cm, fue en promedio del 20% al año 106,107 En la práctica diaria es habitual el tratamiento de lesiones signifi cativamente largas, en las cuales es dable esperar tasas de restenosis elevadas.…”

Section: Tratamiento De La Restenosis Intrastent Del Sector Femoropopunclassified

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A novel mechanism explaining early lumen loss following balloon angioplasty for the treatment of in-stent restenosis

Cited by 9 publications

References 6 publications

Simple balloon dilation for drug-eluting in-stent restenosis: An optical coherent tomography analysis

Simple balloon dilation for drug-eluting in-stent restenosis: An optical coherent tomography analysis

<b>Poststenting Axial Redistribution of Atherosclerotic Plaque Into the Reference Segments and Lumen Reduction at the Stent Edge</b>

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