Mechanisms of lumen enlargement after excimer laser coronary angioplasty. An intravascular ultrasound study
- PMID: 8521561
- DOI: 10.1161/01.cir.92.12.3408
Mechanisms of lumen enlargement after excimer laser coronary angioplasty. An intravascular ultrasound study
Abstract
Background: The mechanisms of excimer laser coronary angioplasty (ELCA) have never been studied in human coronary arteries in vivo.
Methods and results: ELCA was used to treat 202 lesions in 190 patients. Forty-nine lesions in 48 patients were studied by use of sequential (before and after ELCA and after adjunctive device therapy) intravascular ultrasound (IVUS). External elastic membrane (EEM), lumen, and plaque+media (P+M = EEM-lumen) cross-sectional areas (CSAs) and lesion arcs of calcium were measured before and after ELCA and after adjunct device use. Lumen improvement after ELCA (1.4 +/- 0.5 to 2.7 +/- 0.8 mm2) was the result of both tissue ablation (decrease in P+M CSA from 16.8 +/- 7.1 to 15.9 +/- 6.7 mm2, P < .0001) and vessel expansion (increase in EEM CSA from 18.2 +/- 7.1 to 18.6 +/- 6.8 mm2, P = .0245), with no change in calcium. The decrease in P+M CSA was 39% of the CSA of the laser catheter used. Dissections were present in 39% of lesions, 84% within superficial calcium; fibrocalcific deposits developed a "fragmented" appearance.
Conclusions: ELCA increased lumen CSA by both atheroablation and vessel expansion without calcium ablation. Superficial fibrocalcific deposits developed a characteristic fragmented appearance. These findings support both photoablation and forced vessel expansion as mechanisms of lumen enlargement and plaque dissection after ELCA.
Similar articles
-
Intravascular ultrasound findings after excimer laser coronary angioplasty.Cathet Cardiovasc Diagn. 1996 Feb;37(2):113-8. doi: 10.1002/(SICI)1097-0304(199602)37:2<113::AID-CCD1>3.0.CO;2-G. Cathet Cardiovasc Diagn. 1996. PMID: 8808062
-
Treatment of in-stent restenosis with excimer laser coronary angioplasty: mechanisms and results compared with PTCA alone.Circulation. 1997 Oct 7;96(7):2183-9. doi: 10.1161/01.cir.96.7.2183. Circulation. 1997. PMID: 9337188 Clinical Trial.
-
Arterial remodeling after coronary angioplasty: a serial intravascular ultrasound study.Circulation. 1996 Jul 1;94(1):35-43. doi: 10.1161/01.cir.94.1.35. Circulation. 1996. PMID: 8964115
-
Intravascular ultrasound for evaluation of coronary arteries.Herz. 1996 Apr;21(2):78-89. Herz. 1996. PMID: 8682441 Review.
-
Lessons from intravascular ultrasonography: observations during interventional angioplasty procedures.J Clin Ultrasound. 1993 Nov-Dec;21(9):589-607. doi: 10.1002/jcu.1870210906. J Clin Ultrasound. 1993. PMID: 8227389 Review.
Cited by
-
Contemporary Management of Severely Calcified Coronary Lesions.J Pers Med. 2022 Oct 3;12(10):1638. doi: 10.3390/jpm12101638. J Pers Med. 2022. PMID: 36294777 Free PMC article. Review.
-
Calcium Modification Therapies in Contemporary Percutaneous Coronary Intervention.Curr Cardiol Rev. 2022;18(1):e281221199533. doi: 10.2174/1573403X18666211228095457. Curr Cardiol Rev. 2022. PMID: 34963434 Free PMC article. Review.
-
Therapeutic Approach to Calcified Coronary Lesions: Disruptive Technologies.Curr Cardiol Rep. 2021 Mar 5;23(4):33. doi: 10.1007/s11886-021-01458-7. Curr Cardiol Rep. 2021. PMID: 33666772 Review.
-
Imaging during percutaneous coronary intervention for optimizing outcomes.Indian Heart J. 2018 Dec;70 Suppl 3(Suppl 3):S456-S465. doi: 10.1016/j.ihj.2018.08.012. Epub 2018 Aug 18. Indian Heart J. 2018. PMID: 30595307 Free PMC article. Review.
-
Complex, high-risk, and indicated percutaneous coronary angioplasty in essentially calcified stented coronary lesions using excimer laser coronary atherectomy with contrast mix injection.Postepy Kardiol Interwencyjnej. 2023 Sep;19(3):209-216. doi: 10.5114/aic.2023.131473. Epub 2023 Sep 27. Postepy Kardiol Interwencyjnej. 2023. PMID: 37854964 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
