INTRAVASCULAR ULTRASOUND PREDICTORS OF RESTENOSIS AFTER BALLOON ANGIOPLASTY OF THE FEMOROPOPLITEAL ARTERY

Objectives: To determine intravascular ultrasound parameters related t o restenosis following percutaneous transluminal balloon angioplasty ( PTA) of the femoropopliteal artery. Design: Prospective study. Materia ls and methods: Patients were studied with intravascular ultrasound be fore and after angiographic successful PTA (n=114). Intravascular ultr asound cross-sections obtained with 1 cm interval in the dilated segme nt were analysed. A distinction was made between anatomic (duplex scan ning) and clinical (Rutherford criteria) restenosis assessed within 1 month and at 6 months after PTA. Results: Intravascular ultrasound pre dictors of 1 month anatomic outcome were lumen area stenosis after PTA , lumen area increase, plaque area decrease, and area stenosis decreas e; predictor of 6 months anatomic outcome was area stenosis after PTA. Multivariate analysis revealed that area stenosis after PTA was the o nly independent predictor of both 1 and 6 months anatomic outcome. Int ravascular ultrasound predictors of 1 month clinical outcome were the presence of hard lesion and the mean arc of hard lesion. Multivariate analysis revealed that the mean are of hard lesion was the only indepe ndent predictor of 1 month clinical outcome. No predictors for 6 month s clinical outcome were found. Conclusions: Intravascular ultrasound c an elucidate parameters predictive of restonosis after PTA. The strong est intravascular ultrasound parameter predictive of anatomic restenos is was a larger area stenosis after PTA.