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| Plaque Characteristics and Acute Percutaneous Coronary Intervention Outcomes According to the Remodeling Pattern in Diseased Saphenous Vein Graft: Intravascular Ultrasound Analysis |
| 1전남대학교병원 심장센터, 2Cardiovascular Research Foundation, New York, New York, 3중앙대학교병원심장센터, 4인제대학교일산백병원, 5서울의료원, 6Cardiovascular Research Institute/Medstar Research Institute, Washington Hospital Center, Washington, DC |
| 홍영준1, 정명호1, Gary S. Mintz2, 김상욱3, 이성윤4, 김석연5, 안영근1, 김주한1, Augusto D. Pichard6, Lowell F. Satler6, Ron Waksman6, Kenneth M. Kent6, William O. Suddath6, 조정관1, 박종춘1, Neil J. Weissman6, 강정채1 |
We evaluated pre- and post-percutaneous coronary intervention (PCI) intravascular ultrasound (IVUS) images of 311 saphenous vein graft (SVG) lesions and compared IVUS findings between lesions with positive remodeling (PR, n=113) and those with intermediate/negative remodeling (IR/NR, n=198). Remodeling index was the ratio of the lesion site SVG area to the mean of the proximal and distal references (PR: remodeling index (RI) >1.05, IR: 0.95≤RI≤1.05, NR: IR<0.95). Results: Aortoostial lesions were observed more frequently in PR lesions compared with IR/NR lesions. Lesion site plaque burden was significantly greater and the presence of hypoechoic plaque, plaque rupture, multiple plaque rupture, and an intraluminal mass were significantly more common in PR lesions than in IR/NR lesions. Plaque cavity area was significantly greater in PR lesions compared with IR/NR lesions. Post-PCI no-reflow and post-PCI PP were more frequently observed, and maximum PP area and PP volume were significantly greater after PCI for PR lesions than for IR/NR lesions (Table). Conclusions: SVG lesions with PR are associated with more vulnerable plaque characteristics and more no-reflow and PP after PCI.
|
Variables |
PR lesions
(n=113) |
IR/NR lesions (n=198) |
p value |
|
RI |
1.17±0.14 |
0.94±0.09 |
0.002 |
|
Aortoostial lesions |
14 (12%) |
50 (25%) |
0.007 |
|
Plaque burden (%) |
80.6±9.2 |
73.5±10.5 |
<0.001 |
|
Hypoechoic plaque |
67 (59%) |
72 (36%) |
0.001 |
|
Plaque rupture |
29 (26%) |
32 (16%) |
0.042 |
|
Multiple plaque rupture |
14 (12%) |
10 (5%) |
0.020 |
|
Plaque cavity area (mm2) |
0.83±1.43 |
0.42±1.07 |
0.009 |
|
Intraluminal mass |
67 (59%) |
82 (41%) |
0.002 |
|
Post-PCI no-reflow |
21 (19%) |
18 (9%) |
0.019 |
|
Post-PCI PP |
60 (53%) |
54 (27%) |
<0.001 |
|
PP volume (mm3) |
0.86±1.30 |
0.34±0.74 |
<0.001 |
|
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