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Mechanisms of acute lumen gain following cutting balloon angioplasty in calcified and noncalcified lesions: An intravascular ultrasound study
Author(s) -
Okura Hiroyuki,
Hayase Motoya,
Shimodozono Shinichi,
Kobayashi Toru,
Sano Kazuya,
Matsushita Toyoaki,
Kondo Taizo,
Kijima Mikihiko,
Nishikawa Hideo,
Kurogane Hiroyuki,
Aizawa Tadanori,
Hosokawa Hiroaki,
Suzuki Takahiko,
Yamaguchi Tetsu,
Bonneau Heidi N.,
Yock Paul G.,
Fitzgerald Peter J.
Publication year - 2002
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/ccd.10344
Subject(s) - medicine , intravascular ultrasound , lumen (anatomy) , balloon , angioplasty , lesion , nuclear medicine , radiology , cardiology , surgery
Several studies have shown that mechanisms for lumen enlargement following conventional balloon angioplasty (BA) consist of plaque reduction and vessel expansion. To assess the mechanisms of lumen enlargement after Cutting Balloon (CB) angioplasty, intravascular ultrasound images were analyzed in 180 lesions (89 CB and 91 BA). External elastic membrane (EEM) cross‐sectional area (CSA), lumen CSA, and plaque plus media (P+M) CSA were measured before and after angioplasty. In the CB group, lower balloon pressure was utilized ( P < 0.0001). ΔP+M CSA was significantly larger ( P = 0.02) and Δlumen CSA showed a trend toward being larger ( P = 0.07) compared to BA group. For noncalcified lesions, CB resulted in a larger ΔP+M CSA ( P < 0.05) and a smaller ΔEEM CSA ( P = 0.10) than BA. For calcified lesions, Δlumen CSA was significantly larger in the CB group ( P < 0.05) without significant differences in ΔEEM CSA and ΔP+M CSA. Dissections complicated with calcified lesions were associated with larger Δlumen CSA for the CB group. In conclusion, for noncalcified lesions, CB achieves similar luminal dimensions with larger plaque reduction and less vessel expansion compared to BA. On the other hand, for calcified lesions, the CB achieves larger lumen gain, especially in lesions with evidence of dissections. Cathet Cardiovasc Intervent 2002;57:429–436. © 2002 Wiley‐Liss, Inc.