Abstract
We investigated by intravascular ultrasound (IVUS) the mechanism of action of cutting balloon (CB) angioplasty in patients with in-stent restenosis. Seventy-one consecutive restenotic lesions of 66 patients were studied by quantitative coronary angiography (QCA) and IVUS before, immediately after, and, in 20 cases, at 24-hr time interval after CB. CB was selected according to 1:1 CB-to-stent ratio and inflated at 8 atm for 60-90 sec. Both IVUS planar and volumetric (Simpson's rule, 25 patients) analysis were carried out. IVUS measurements included external elastic membrane area (EEMA), stent area (SA), minimal lumen area (MLA), and restenosis area (RA). Following CB, QCA analysis showed increase of minimal lumen diameter (1.17 ± 0.46 vs. 2.45 ± 0.51 mm; P <0.0001) and decrease of diameter stenosis (64% ± 13% vs. 21% ± 9%; P <0.0001). IVUS measurements showed a significant increase of MLA (2.18 ± 0.80 vs. 7.31 ± 1.8 mm2; P <0.0001), SA (9.62 ± 2.6 vs. 10.7 ± 2.75 mm2; P <0.0001), and EEMA (17.27 <5 vs. 18.1 ± 5 mm2; P <0.0001) and a decrease of RA (7.43 ± 2.63 vs. 3.45 ± 1.39 mm2; P <0.0001). No significant change was observed in the original plaque + media area (7.65 ± 3 vs. 7.38 ± 2.9 mm2; P = NS). Thus, of the total lumen enlargement (5.13 ± 1.85 mm2), 23% was the result of increase in mean SA, whereas 77% was the result of a decrease in mean RA. These changes were associated with a 5% increase in EEMA. IVUS volumetric changes paralleled planar variations. Angiographic and IVUS changes were well maintained at 24 hr. CB enlarges coronary lumen mainly by in-stent tissue reduction associated with a moderate degree of additional stent expansion. Favorable QCA and IVUS acute results are maintained at 24 hr.
| Original language | English |
|---|---|
| Pages (from-to) | 166-173 |
| Number of pages | 8 |
| Journal | Catheterization and Cardiovascular Interventions |
| Volume | 56 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 2002 |
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Keywords
- Cutting balloon
- In-stent restenosis
- Intravascular ultrasound
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Radiology Nuclear Medicine and imaging
Cite this
Mechanism of cutting balloon angioplasty for in-stent restenosis : An intravascular ultrasound study. / Montorsi, Piero; Galli, Stefano; Fabbiocchi, Franco; Loaldi, Alessandro; Trabattoni, Daniela; Grancini, Luca; Cozzi, Sergio; Ravagnani, Paolo; Parodi, Oberdan; Bartorelli, Antonio L.
In: Catheterization and Cardiovascular Interventions, Vol. 56, No. 2, 2002, p. 166-173.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Mechanism of cutting balloon angioplasty for in-stent restenosis
T2 - An intravascular ultrasound study
AU - Montorsi, Piero
AU - Galli, Stefano
AU - Fabbiocchi, Franco
AU - Loaldi, Alessandro
AU - Trabattoni, Daniela
AU - Grancini, Luca
AU - Cozzi, Sergio
AU - Ravagnani, Paolo
AU - Parodi, Oberdan
AU - Bartorelli, Antonio L.
PY - 2002
Y1 - 2002
N2 - We investigated by intravascular ultrasound (IVUS) the mechanism of action of cutting balloon (CB) angioplasty in patients with in-stent restenosis. Seventy-one consecutive restenotic lesions of 66 patients were studied by quantitative coronary angiography (QCA) and IVUS before, immediately after, and, in 20 cases, at 24-hr time interval after CB. CB was selected according to 1:1 CB-to-stent ratio and inflated at 8 atm for 60-90 sec. Both IVUS planar and volumetric (Simpson's rule, 25 patients) analysis were carried out. IVUS measurements included external elastic membrane area (EEMA), stent area (SA), minimal lumen area (MLA), and restenosis area (RA). Following CB, QCA analysis showed increase of minimal lumen diameter (1.17 ± 0.46 vs. 2.45 ± 0.51 mm; P <0.0001) and decrease of diameter stenosis (64% ± 13% vs. 21% ± 9%; P <0.0001). IVUS measurements showed a significant increase of MLA (2.18 ± 0.80 vs. 7.31 ± 1.8 mm2; P <0.0001), SA (9.62 ± 2.6 vs. 10.7 ± 2.75 mm2; P <0.0001), and EEMA (17.27 <5 vs. 18.1 ± 5 mm2; P <0.0001) and a decrease of RA (7.43 ± 2.63 vs. 3.45 ± 1.39 mm2; P <0.0001). No significant change was observed in the original plaque + media area (7.65 ± 3 vs. 7.38 ± 2.9 mm2; P = NS). Thus, of the total lumen enlargement (5.13 ± 1.85 mm2), 23% was the result of increase in mean SA, whereas 77% was the result of a decrease in mean RA. These changes were associated with a 5% increase in EEMA. IVUS volumetric changes paralleled planar variations. Angiographic and IVUS changes were well maintained at 24 hr. CB enlarges coronary lumen mainly by in-stent tissue reduction associated with a moderate degree of additional stent expansion. Favorable QCA and IVUS acute results are maintained at 24 hr.
AB - We investigated by intravascular ultrasound (IVUS) the mechanism of action of cutting balloon (CB) angioplasty in patients with in-stent restenosis. Seventy-one consecutive restenotic lesions of 66 patients were studied by quantitative coronary angiography (QCA) and IVUS before, immediately after, and, in 20 cases, at 24-hr time interval after CB. CB was selected according to 1:1 CB-to-stent ratio and inflated at 8 atm for 60-90 sec. Both IVUS planar and volumetric (Simpson's rule, 25 patients) analysis were carried out. IVUS measurements included external elastic membrane area (EEMA), stent area (SA), minimal lumen area (MLA), and restenosis area (RA). Following CB, QCA analysis showed increase of minimal lumen diameter (1.17 ± 0.46 vs. 2.45 ± 0.51 mm; P <0.0001) and decrease of diameter stenosis (64% ± 13% vs. 21% ± 9%; P <0.0001). IVUS measurements showed a significant increase of MLA (2.18 ± 0.80 vs. 7.31 ± 1.8 mm2; P <0.0001), SA (9.62 ± 2.6 vs. 10.7 ± 2.75 mm2; P <0.0001), and EEMA (17.27 <5 vs. 18.1 ± 5 mm2; P <0.0001) and a decrease of RA (7.43 ± 2.63 vs. 3.45 ± 1.39 mm2; P <0.0001). No significant change was observed in the original plaque + media area (7.65 ± 3 vs. 7.38 ± 2.9 mm2; P = NS). Thus, of the total lumen enlargement (5.13 ± 1.85 mm2), 23% was the result of increase in mean SA, whereas 77% was the result of a decrease in mean RA. These changes were associated with a 5% increase in EEMA. IVUS volumetric changes paralleled planar variations. Angiographic and IVUS changes were well maintained at 24 hr. CB enlarges coronary lumen mainly by in-stent tissue reduction associated with a moderate degree of additional stent expansion. Favorable QCA and IVUS acute results are maintained at 24 hr.
KW - Cutting balloon
KW - In-stent restenosis
KW - Intravascular ultrasound
UR - http://www.scopus.com/inward/record.url?scp=0036267150&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036267150&partnerID=8YFLogxK
U2 - 10.1002/ccd.10191
DO - 10.1002/ccd.10191
M3 - Article
C2 - 12112907
AN - SCOPUS:0036267150
VL - 56
SP - 166
EP - 173
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
SN - 1522-1946
IS - 2
ER -