TY - JOUR
T1 - Failure of intravascular ultrasound to predict dissection after balloon angioplasty by using plaque characteristics
AU - Van Der Lugt, A.
AU - Gussenhoven, E. J.
AU - von Birgelen, C.
AU - Tai, J. A.
AU - Pieterman, H.
PY - 1997/1/1
Y1 - 1997/1/1
N2 - Intravascular ultrasound (IVUS) is more sensitive than angiography in the assessment of plaque characteristics before intervention and vascular damage after balloon angioplasty. On the basis of IVUS data, this finding may improve clinical treatment by reducing the incidence of severe dissections after balloon angioplasty. We therefore studied the relation between plaque characteristics and dissections after balloon angioplasty. First, an in vitro study on atherosclerotic arteries (n = 42) was performed in which IVUS images were compared with histologic sections to validate the IVUS technique; second, the in vitro findings were compared with IVUS findings obtained in vive (n = 73). Dissections were observed in 37 histologic sections and visualized on IVUS in 22 (59%) of the corresponding ultrasonic cross- sections; in vivo dissections were demonstrated by IVUS in 46 (63%) cases. Dissections were generally seen at the thinnest raglan of the plaque on both histologic sections (92%) and IVUS cross-sections (in vitro 83%; in vivo 93%). No significant relation was found between pre-interventional plaque characteristics such as composition features and eccentricity and the incidence, location, and extent of postinterventional dissections. Thus IVUS is able to identify dissections after balloon angioplasty, generally occurring at the site of the thinnest plaque diameter. However, neither the incidence nor the severity of these dissections was related to any of the preinterventional plaque characteristics.
AB - Intravascular ultrasound (IVUS) is more sensitive than angiography in the assessment of plaque characteristics before intervention and vascular damage after balloon angioplasty. On the basis of IVUS data, this finding may improve clinical treatment by reducing the incidence of severe dissections after balloon angioplasty. We therefore studied the relation between plaque characteristics and dissections after balloon angioplasty. First, an in vitro study on atherosclerotic arteries (n = 42) was performed in which IVUS images were compared with histologic sections to validate the IVUS technique; second, the in vitro findings were compared with IVUS findings obtained in vive (n = 73). Dissections were observed in 37 histologic sections and visualized on IVUS in 22 (59%) of the corresponding ultrasonic cross- sections; in vivo dissections were demonstrated by IVUS in 46 (63%) cases. Dissections were generally seen at the thinnest raglan of the plaque on both histologic sections (92%) and IVUS cross-sections (in vitro 83%; in vivo 93%). No significant relation was found between pre-interventional plaque characteristics such as composition features and eccentricity and the incidence, location, and extent of postinterventional dissections. Thus IVUS is able to identify dissections after balloon angioplasty, generally occurring at the site of the thinnest plaque diameter. However, neither the incidence nor the severity of these dissections was related to any of the preinterventional plaque characteristics.
UR - http://www.scopus.com/inward/record.url?scp=0031461314&partnerID=8YFLogxK
U2 - 10.1016/S0002-8703(97)70028-0
DO - 10.1016/S0002-8703(97)70028-0
M3 - Article
C2 - 9424068
AN - SCOPUS:0031461314
SN - 0002-8703
VL - 134
SP - 1075
EP - 1081
JO - American heart journal
JF - American heart journal
IS - 6
ER -