Intravascular Ultrasonic Predictors of Intimal Hyperplasia after Coronary Stenting

ABSTRACT

BACKGROUND: Several studies using intravascular ultrasound (IVUS) suggested several factors to predict angiographic restenosis or intimal hyperplasia(IH) after stenting. However, independent factors to predict IH have not been reported. Therefore, we evaluated the independent predictors of IH after stenting. METHODS: The serial (pre- and post-intervention, and follow-up) IVUS images were obtained in 77 patients with single stent implantation (GFX in 46 patients and NIR in 31). The matching IVUS image slices at 4 different sites within the same stent (follow-up lesion site, center of the stent and within 2 mm of proximal and distal margin of stent) were selected for serial comparisons. Total 308 matching images were obtained. A number of pre- and post-intervention IVUS variables including remodeling index =(lesion / proximal reference segment) pre-intervention vessel area were entered into multivariate linear regression analysis model to predict percent IH. RESULTS: The independent IVUS predictors of percent IH were pre-intervention plaque burden at follow-up lesion site (r=.252, p=.027) and proximal margin of the stent (r=.245, p=.034), and pre-intervention plaque burden (r=.334, p=.003) and remodeling index (r=0.353, p=.002) at the center of stent, and remodeling index at distal margin of the stent (r=0.230, p=.046). The percent IH positively correlated with pre-intervention plaque burden and inversely with remodeling index. CONCLUSIONS: The independent IVUS predictors of greater percent IH are larger pre-intervention plaque burden and smaller remodeling index.