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Intravascular ultrasound for evaluation of initial vessel patency and early outcome following directional coronary atherectomy
Author(s) -
Hardt Stefan E.,
Bekeredjian Raffi,
Brachmann Johannes,
Kuecherer Helmut F.,
Hansen Alexander,
Kübler Wolfgang,
Katus Hugo A.
Publication year - 1999
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/(sici)1522-726x(199905)47:1<14::aid-ccd3>3.0.co;2-6
Subject(s) - intravascular ultrasound , medicine , lumen (anatomy) , elastic recoil , cardiology , thrombus , stenosis , atherectomy , radiology , stent , restenosis , lung
Elastic recoil and thrombus formation may potentially occur following directional coronary atherectomy (DCA) confounding the assessment of late vascular remodeling. Since intravascular ultrasound (IVUS) data on early outcome of DCA is not available, we used IVUS to investigate whether elastic recoil or thrombus formation can affect early (4 hr) outcome. Quantitative coronary angiography (QCA) and IVUS were performed in high‐grade coronary lesions in 32 consecutive patients before, immediately after, and 4 hr after DCA. Late clinical follow‐up was obtained after a maximum interval of 2 years. Significant acute elastic recoil was observed by both IVUS (19% ± 14%) and QCA (19% ± 12%), but there was no further recoil after 4 hr. DCA reduced plaque area by 51% ± 13%, an effect that was stable after 4 hr, indicating the absence of relevant thrombus formation. Residual area stenosis by IVUS was not related to the occurrence of late clinical events (n = 8). Mechanical recoil or thrombus formation do not hamper initial lumen gain achieved by DCA. Although QCA significantly underestimated residual plaque burden after DCA when compared to IVUS, the degree of residual area stenosis did not identify patients suffering from cardiac events on follow‐up.Cathet. Cardiovasc. Intervent. 47:14–22, 1999. © 1999 Wiley‐Liss, Inc.