Background-We have shown that probucol reduces restenosis after balloon angioplasty. Whether probucol acted via prevention of neointimal formation or improvement in vascular remodeling could not be addressed by angiography and required the use of intravascular ultrasound (IVUS). Methods and Results-Beginning 30 days before angioplasty, 317 patients were randomly assigned to receive probucol, multivitamins, combined treatment, or placebo. Patients were then treated for 6 months after angioplasty. IVUS examination was performed immediately after angioplasty and at follow-up in 94 patients (111 segments). The cross section selected for serial analysis was the one at the angioplasty site with the smallest lumen area at follow-up. In the placebo group, lumen area decreased by Ϫ1.21Ϯ1.88 mm 2 at follow-up, and wall area and external elastic membrane (EEM) area increased by 1.50Ϯ2.50 and 0.29Ϯ2.93 mm 2 , respectively. Change in lumen area, however, correlated more strongly with the change in EEM area (rϭ0.53, Pϭ0.002) than with the change in wall area (rϭϪ0. 13, Pϭ0.49