冠状动脉内支架置入术前动脉重塑作为内膜增生预测指标的系列血管内超声研究

Preintervention arterial remodeling as a predictor of intimal hyperplasia after intracoronary stenting: a serial intravascular ultrasound study.

作者信息

Hong Myeong-Ki, Park Seong-Wook, Lee Cheol Whan, Kim Jae-Joong, Park Seung-Jung

机构信息

Department of Medicine, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea.

出版信息

Clin Cardiol. 2002 Jan;25(1):11-5. doi: 10.1002/clc.4950250104.

DOI:10.1002/clc.4950250104

PMID:11808832

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6654488/

Abstract

BACKGROUND

The impact of vascular remodeling pattern on intimal hyperplasia (IH) after coronary stenting is unknown.

HYPOTHESIS

The preintervention remodeling pattern of the lesion might be associated with IH after the coronary stenting procedure.

METHODS

Serial (pre-, post-stent implantation, and follow-up) intravascular ultrasound (IVUS) images were obtained in 58 patients with single-stent implantation (GFX stents in 41 and NIR in 17). The matching IVUS image slices at the preintervention lesion site were selected for serial comparisons. The remodeling index (RI) was defined as lesion/proximal reference external elastic membrane cross-sectional area (CSA) at preintervention lesion site. Adequate remodeling was defined as a RI > 0.95 and inadequate remodeling as a RI < or = 0.95. Vessel stretching, percent vessel stretching, and percent IH CSA, as well as pre- and postintervention IVUS variables were evaluated according to the remodeling pattern.

RESULTS

The percent IH CSA was 31% in adequate remodeling (n = 29, mean RI = 1.05) and 41% in inadequate remodeling (n = 29, mean RI = 0.88) (p = 0.049). Percent vessel stretching was 15% in adequate remodeling and 22% in inadequate remodeling (p = 0.007). The RI inversely correlated with percent vessel stretching (r = -0.435, p = 0.001).

CONCLUSIONS

Compared with preintervention adequate remodeling, inadequate remodeling was associated with increased percent IH CSA, which might be related with more vessel stretching.

摘要

背景

血管重塑模式对冠状动脉支架置入术后内膜增生（IH）的影响尚不清楚。

假设

病变的干预前重塑模式可能与冠状动脉支架置入术后的内膜增生有关。

方法

对58例单支架置入患者（41例植入GFX支架，17例植入NIR支架）进行系列（干预前、支架植入后及随访）血管内超声（IVUS）检查。选择干预前病变部位匹配的IVUS图像切片进行系列比较。重塑指数（RI）定义为干预前病变部位病变/近端参考外弹力膜横截面积（CSA）。充分重塑定义为RI>0.95，不充分重塑定义为RI≤0.95。根据重塑模式评估血管扩张、血管扩张百分比、内膜增生CSA百分比以及干预前后的IVUS变量。

结果

充分重塑组（n = 29，平均RI = 1.05）内膜增生CSA百分比为31%，不充分重塑组（n = 29，平均RI = 0.88）为41%（p = 0.049）。充分重塑组血管扩张百分比为15%，不充分重塑组为22%（p = 0.007）。RI与血管扩张百分比呈负相关（r = -0.435，p = 0.001）。