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
Wem. Kok et al., 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, J AM COL C, 35(2), 2000, pp. 382-388
Citations number
30
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
OBJECTIVES We investigated whether the greater late lumen loss after corona
ry balloon angioplasty in the proximal left anterior descending artery (P-L
AD) compared with that in other segments might be related to differences in
vascular dimensions or morphology as determined by angiography and intrava
scular 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 quantita
tive angiography and 30 MHz intravascular ultrasound imaging after successf
ul balloon angioplasty, Vessel wall morphology was compared among three pro
ximal and three nonproximal segments. Follow-up quantitative angiography fo
r late lumen loss calculation was performed in 168 lesions. Multivariate an
alysis 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 < 0.00
1). 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 refere
nce segment plaque area (5.4 +/- 2.2 mm(2) vs. 4.7 +/- 1.9 mm(2), 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 t
he P-LAD is not explained by differences in atherosclerotic plaque burden o
r in vessel wall damage. (J Am Coll Cardiol 2000;35:382-8) (C) 2000 by the
American College of Cardiology.