Impact of deep vessel wall injury on acute response and remodeling of coronary artery segments after cutting balloon angioplasty
| Autor: | Yasuhiro Honda, Tetsu Yamaguchi, Heidi N. Bonneau, Toru Kataoka, Peter J. Fitzgerald, Paul G. Yock, Takahiko Suzuki, Mamoo Nakamura |
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| Rok vydání: | 2003 |
| Předmět: |
Male
medicine.medical_specialty Soft Tissue Injuries medicine.medical_treatment Lumen (anatomy) Coronary Disease Statistics Nonparametric Lesion Angioplasty Internal medicine Intravascular ultrasound medicine Humans Ultrasonography Interventional Aged Wound Healing Chi-Square Distribution medicine.diagnostic_test business.industry Vascular disease Ultrasound Middle Aged medicine.disease Coronary Vessels medicine.anatomical_structure Cardiology Female Cutting balloon medicine.symptom Cardiology and Cardiovascular Medicine business Angioplasty Balloon Artery |
| Zdroj: | The American Journal of Cardiology. 91:6-11 |
| ISSN: | 0002-9149 |
| DOI: | 10.1016/s0002-9149(02)02989-2 |
| Popis: | Deep vessel wall injury is believed to affect vessel dimension following coronary intervention. The cutting balloon is designed to treat coronary artery stenoses with dilatation and surgical incisions, thereby reducing excess vessel injury. This study examines the effect of deep vessel wall injury on acute and late coronary arterial response after cutting balloon angioplasty. Serial volumetric intravascular ultrasound (IVUS) analyses were performed in 63 lesions treated with cutting balloon angioplasty alone. Before intervention, the longitudinal range of the lesion segment that included the smallest lumen area (LA) was determined as LA4 mm(2) and/or LA stenosis60%. The exact corresponding site at postintervention and follow-up was aligned using peri- and intravascular landmarks. Average vessel area (VA), plaque area (PA), and LA were measured. Lesion segments were categorized as with or without deep vessel wall injury, which was defined as the presence of plaque/vessel wall fracture extending to the sonolucent (medial) layer. Before intervention, the lesion vessel size of deep injury group was smaller than that of the nondeep injury group (p0.05 for average VA and PA), whereas average lesion LA, lesion length, and reference vessel size did not differ. Immediately after cutting balloon angioplasty, the deep injury group showed a significant increase in VA (p0.0001) and a lesser decrease in PA (p0.01) compared with the nondeep injury group. During follow-up, the increase of VA tended to be greater in the deep injury group than in the nondeep injury group (p = 0.06), whereas the change of PA did not differ. Consequently, LA decrease was less in the deep injury group than in the nondeep injury group (p0.05). From these results, it is suggested that deep vessel wall injury tends to occur in lesions with relatively small size and such lesions show favorable vessel response after cutting balloon angioplasty. |
| Databáze: | OpenAIRE |
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