Document Detail


Greater late lumen loss after successful coronary balloon angioplasty in the proximal left anterior descending coronary artery is not explained by extent of vessel wall damage or plaque burden.
MedLine Citation:
PMID:  10676685     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We investigated whether the greater late lumen loss after coronary balloon angioplasty in the proximal left anterior descending artery (P-LAD) compared with that in other segments might be related to differences in vascular dimensions or morphology as determined by angiography and intravascular ultrasound imaging. BACKGROUND: The greater late lumen loss after angioplasty in the P-LAD that has been observed in several studies has not been explained. METHODS: We studied 178 patients and 194 coronary artery lesions by quantitative angiography and 30 MHz intravascular ultrasound imaging after successful balloon angioplasty. Vessel wall morphology was compared among three proximal and three nonproximal segments. Follow-up quantitative angiography for late lumen loss calculation was performed in 168 lesions. Multivariate analysis was used to determine predictors of late lumen loss. RESULTS: Absolute and relative late loss were significantly greater at the P-LAD compared with the pooled group of other segments (0.42 +/- 0.60 mm vs. 0.10 +/- 0.48 mm, p = 0.0008 and 0.14 +/- 0.24 vs. 0.03 +/- 0.17, p < 0.001). Also, a greater percentage of calcific lesions (65% vs. 44%, p = 0.034), a lower incidence of rupture (51% vs. 74%, p = 0.009) and a larger reference segment plaque area (5.4 +/- 2.2 mm2 vs. 4.7 +/- 1.9 mm2, p = 0.05) were found in the P-LAD. In multivariate analysis however, these variables were not predictive of late loss. CONCLUSIONS: Greater late lumen loss after coronary balloon angioplasty of the P-LAD is not explained by differences in atherosclerotic plaque burden or in vessel wall damage.
Authors:
W E Kok; R J Peters; G Pasterkamp; C Di Mario; P W Serruys; M Prins; C A Visser
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  35     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2000 Feb 
Date Detail:
Created Date:  2000-02-29     Completed Date:  2000-02-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  382-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Free University Hospital Amsterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Aneurysm, Dissecting / radiography,  ultrasonography
Angioplasty, Transluminal, Percutaneous Coronary*
Coronary Aneurysm / radiography,  ultrasonography
Coronary Angiography
Coronary Disease / radiography,  therapy*,  ultrasonography
Coronary Vessels* / injuries,  ultrasonography
Female
Humans
Male
Middle Aged
Postoperative Complications* / radiography,  ultrasonography
Recurrence
Rupture, Spontaneous / radiography,  ultrasonography
Treatment Failure
Ultrasonography, Interventional

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