Arterial remodeling influences the development of intimal hyperplasia after stent implantation

OBJECTIVES We examined whether preinterventional arterial remodeling influe nced the interventional results after stenting. BACKGROUND Arterial remodeling is seen in atherosclerotic lesions, and it m ay play an important role in the early stage of atherosclerosis. METHODS We examined 113 lesions that underwent elective stenting using tubu lar slotted stents under intravascular ultrasound guidance. The lesions wer e divided into three groups-adequate, intermediate and inadequate remodelin g group-according to preinterventional arterial remodeling. The patients we re subjected to coronary angiography and intravascular ultrasound evaluatio n on average 6.4 months after stenting. RESULTS At baseline and immediately after stenting, there were no differenc es in quantitative angiographic analysis among remodeling groups. However, the plaque cross-sectional area (CSA) in the minimal lumen CSA at preinterv ention and intimal hyperplasia CSA at follow-up were significantly larger i n the adequate remodeling group than in the inadequate remodeling group. Th e restenosis rate of stenting for the lesions with inadequate arterial remo deling was very low (9.4%). A significant positive correlation was found be tween preinterventional plaque CSA and intimal hyperplasia CSA at follow-up (r = 0.47, p < 0.0001). Moreover, remodeling index significantly correlate d with relative intimal hyperplasia CSA (r = 0.28, p < 0.01). CONCLUSIONS Preinterventional arterial remodeling influenced the developmen t of intimal hyperplasia after stenting. (J Am Cell Cardiol 2001;37:70-5) ( C) 2001 by the American College of Cardiology.