Impact of preinterventional arterial remodeling on neointimal hyperplasia after implantation of (non-polymer-encapsulated) paclitaxel-coated stents

A serial volumetric intravascular ultrasound analysis from the Asian Paclitaxel-Eluting Stent Clinical Trial (ASPECT)

Gary S. Mintz, Adrienne Tinana, Myeongki Hong, Cheol Whan Lee, Jae Joong Kim, Neal E. Fearnot, Seong Wook Park, Seung Jung Park, Neil J. Weissman

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Background-This study used serial volumetric intravascular ultrasound (IVUS) to evaluate the effect of preinterventional arterial remodeling on in-stent intimal hyperplasia (IH) after implantation of non-polymer-encapsulated paclitaxelcoated stents. Methods and Results-Patients were randomized to placebo or one of two doses of paclitaxel (low dose, 1.28 μg/mm 2 ; high dose, 3.10 μg/mm 2 ). Complete preinterventional, post-stent implantation, and follow-up IVUS were available in 18 low-dose and 21 high-dose patients. IH volumes were similar in low-dose and high-dose patients: 17.6 ± mm 3 in low-dose patients and 13.1 ± 13.3 mm 3 in high-dose patients (P = 0.3). Therefore, IVUS findings in low- and high-dose patients were combined. Preinterventional remodeling was assessed by comparing lesion site to proximal and distal reference arterial area: positive remodeling (lesion > proximal reference, n=13), intermediate remodeling (distal reference < lesion < proximal reference, n = 13), and negative remodeling (lesion < distal reference, n = 13). During follow-up, there was a decrease in lumen volume in positive remodeling lesions (from 106 ± 30 to 90 ± 27 mm 3 ; P = 0.0067) and in intermediate remodeling lesions (from 97 ± 28 to 76 ± mm 3 ; P = 0.0004), but not in negative remodeling lesions (99 ± 27 versus 92 ± 32 mm 3 ; P = 0.15). The follow-up IH volume was lower in negative remodeling lesions (5 ± 7 mm 3 ) compared with positive remodeling (20 ± 14 mm 3 ; P = 0.0051) and intermediate remodeling lesions (20 ± 15 mm 3 ; P = 0.0043); however, IH volume was virtually identical in positive and intermediate remodeling lesions. Multivariate linear regression analysis determined that remodeling and inflation pressure were independent predictors of IH volume; variables tested in the model included diabetes, acute coronary syndromes, dose, remodeling, and preinterventional plaque burden. Conclusions-Preinterventional arterial remodeling, especially negative remodeling, influences neointimal hyperplasia suppression after implantation of non-polymer-encapsulated paclitaxel-coated stents.

Original languageEnglish
Pages (from-to)1295-1298
Number of pages4
JournalCirculation
Volume108
Issue number11
DOIs
Publication statusPublished - 2003 Sep 16

Fingerprint

Tunica Intima
Paclitaxel
Hyperplasia
Stents
Clinical Trials
Economic Inflation
Acute Coronary Syndrome
Linear Models
Placebos
Regression Analysis
Pressure

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

@article{c6a7a5ea2744463d9239e1b4340330aa,
title = "Impact of preinterventional arterial remodeling on neointimal hyperplasia after implantation of (non-polymer-encapsulated) paclitaxel-coated stents: A serial volumetric intravascular ultrasound analysis from the Asian Paclitaxel-Eluting Stent Clinical Trial (ASPECT)",
abstract = "Background-This study used serial volumetric intravascular ultrasound (IVUS) to evaluate the effect of preinterventional arterial remodeling on in-stent intimal hyperplasia (IH) after implantation of non-polymer-encapsulated paclitaxelcoated stents. Methods and Results-Patients were randomized to placebo or one of two doses of paclitaxel (low dose, 1.28 μg/mm 2 ; high dose, 3.10 μg/mm 2 ). Complete preinterventional, post-stent implantation, and follow-up IVUS were available in 18 low-dose and 21 high-dose patients. IH volumes were similar in low-dose and high-dose patients: 17.6 ± mm 3 in low-dose patients and 13.1 ± 13.3 mm 3 in high-dose patients (P = 0.3). Therefore, IVUS findings in low- and high-dose patients were combined. Preinterventional remodeling was assessed by comparing lesion site to proximal and distal reference arterial area: positive remodeling (lesion > proximal reference, n=13), intermediate remodeling (distal reference < lesion < proximal reference, n = 13), and negative remodeling (lesion < distal reference, n = 13). During follow-up, there was a decrease in lumen volume in positive remodeling lesions (from 106 ± 30 to 90 ± 27 mm 3 ; P = 0.0067) and in intermediate remodeling lesions (from 97 ± 28 to 76 ± mm 3 ; P = 0.0004), but not in negative remodeling lesions (99 ± 27 versus 92 ± 32 mm 3 ; P = 0.15). The follow-up IH volume was lower in negative remodeling lesions (5 ± 7 mm 3 ) compared with positive remodeling (20 ± 14 mm 3 ; P = 0.0051) and intermediate remodeling lesions (20 ± 15 mm 3 ; P = 0.0043); however, IH volume was virtually identical in positive and intermediate remodeling lesions. Multivariate linear regression analysis determined that remodeling and inflation pressure were independent predictors of IH volume; variables tested in the model included diabetes, acute coronary syndromes, dose, remodeling, and preinterventional plaque burden. Conclusions-Preinterventional arterial remodeling, especially negative remodeling, influences neointimal hyperplasia suppression after implantation of non-polymer-encapsulated paclitaxel-coated stents.",
author = "Mintz, {Gary S.} and Adrienne Tinana and Myeongki Hong and Lee, {Cheol Whan} and Kim, {Jae Joong} and Fearnot, {Neal E.} and Park, {Seong Wook} and Park, {Seung Jung} and Weissman, {Neil J.}",
year = "2003",
month = "9",
day = "16",
doi = "10.1161/01.CIR.0000091254.73351.D6",
language = "English",
volume = "108",
pages = "1295--1298",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "11",

}

Impact of preinterventional arterial remodeling on neointimal hyperplasia after implantation of (non-polymer-encapsulated) paclitaxel-coated stents : A serial volumetric intravascular ultrasound analysis from the Asian Paclitaxel-Eluting Stent Clinical Trial (ASPECT). / Mintz, Gary S.; Tinana, Adrienne; Hong, Myeongki; Lee, Cheol Whan; Kim, Jae Joong; Fearnot, Neal E.; Park, Seong Wook; Park, Seung Jung; Weissman, Neil J.

In: Circulation, Vol. 108, No. 11, 16.09.2003, p. 1295-1298.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Impact of preinterventional arterial remodeling on neointimal hyperplasia after implantation of (non-polymer-encapsulated) paclitaxel-coated stents

T2 - A serial volumetric intravascular ultrasound analysis from the Asian Paclitaxel-Eluting Stent Clinical Trial (ASPECT)

AU - Mintz, Gary S.

AU - Tinana, Adrienne

AU - Hong, Myeongki

AU - Lee, Cheol Whan

AU - Kim, Jae Joong

AU - Fearnot, Neal E.

AU - Park, Seong Wook

AU - Park, Seung Jung

AU - Weissman, Neil J.

PY - 2003/9/16

Y1 - 2003/9/16

N2 - Background-This study used serial volumetric intravascular ultrasound (IVUS) to evaluate the effect of preinterventional arterial remodeling on in-stent intimal hyperplasia (IH) after implantation of non-polymer-encapsulated paclitaxelcoated stents. Methods and Results-Patients were randomized to placebo or one of two doses of paclitaxel (low dose, 1.28 μg/mm 2 ; high dose, 3.10 μg/mm 2 ). Complete preinterventional, post-stent implantation, and follow-up IVUS were available in 18 low-dose and 21 high-dose patients. IH volumes were similar in low-dose and high-dose patients: 17.6 ± mm 3 in low-dose patients and 13.1 ± 13.3 mm 3 in high-dose patients (P = 0.3). Therefore, IVUS findings in low- and high-dose patients were combined. Preinterventional remodeling was assessed by comparing lesion site to proximal and distal reference arterial area: positive remodeling (lesion > proximal reference, n=13), intermediate remodeling (distal reference < lesion < proximal reference, n = 13), and negative remodeling (lesion < distal reference, n = 13). During follow-up, there was a decrease in lumen volume in positive remodeling lesions (from 106 ± 30 to 90 ± 27 mm 3 ; P = 0.0067) and in intermediate remodeling lesions (from 97 ± 28 to 76 ± mm 3 ; P = 0.0004), but not in negative remodeling lesions (99 ± 27 versus 92 ± 32 mm 3 ; P = 0.15). The follow-up IH volume was lower in negative remodeling lesions (5 ± 7 mm 3 ) compared with positive remodeling (20 ± 14 mm 3 ; P = 0.0051) and intermediate remodeling lesions (20 ± 15 mm 3 ; P = 0.0043); however, IH volume was virtually identical in positive and intermediate remodeling lesions. Multivariate linear regression analysis determined that remodeling and inflation pressure were independent predictors of IH volume; variables tested in the model included diabetes, acute coronary syndromes, dose, remodeling, and preinterventional plaque burden. Conclusions-Preinterventional arterial remodeling, especially negative remodeling, influences neointimal hyperplasia suppression after implantation of non-polymer-encapsulated paclitaxel-coated stents.

AB - Background-This study used serial volumetric intravascular ultrasound (IVUS) to evaluate the effect of preinterventional arterial remodeling on in-stent intimal hyperplasia (IH) after implantation of non-polymer-encapsulated paclitaxelcoated stents. Methods and Results-Patients were randomized to placebo or one of two doses of paclitaxel (low dose, 1.28 μg/mm 2 ; high dose, 3.10 μg/mm 2 ). Complete preinterventional, post-stent implantation, and follow-up IVUS were available in 18 low-dose and 21 high-dose patients. IH volumes were similar in low-dose and high-dose patients: 17.6 ± mm 3 in low-dose patients and 13.1 ± 13.3 mm 3 in high-dose patients (P = 0.3). Therefore, IVUS findings in low- and high-dose patients were combined. Preinterventional remodeling was assessed by comparing lesion site to proximal and distal reference arterial area: positive remodeling (lesion > proximal reference, n=13), intermediate remodeling (distal reference < lesion < proximal reference, n = 13), and negative remodeling (lesion < distal reference, n = 13). During follow-up, there was a decrease in lumen volume in positive remodeling lesions (from 106 ± 30 to 90 ± 27 mm 3 ; P = 0.0067) and in intermediate remodeling lesions (from 97 ± 28 to 76 ± mm 3 ; P = 0.0004), but not in negative remodeling lesions (99 ± 27 versus 92 ± 32 mm 3 ; P = 0.15). The follow-up IH volume was lower in negative remodeling lesions (5 ± 7 mm 3 ) compared with positive remodeling (20 ± 14 mm 3 ; P = 0.0051) and intermediate remodeling lesions (20 ± 15 mm 3 ; P = 0.0043); however, IH volume was virtually identical in positive and intermediate remodeling lesions. Multivariate linear regression analysis determined that remodeling and inflation pressure were independent predictors of IH volume; variables tested in the model included diabetes, acute coronary syndromes, dose, remodeling, and preinterventional plaque burden. Conclusions-Preinterventional arterial remodeling, especially negative remodeling, influences neointimal hyperplasia suppression after implantation of non-polymer-encapsulated paclitaxel-coated stents.

UR - http://www.scopus.com/inward/record.url?scp=0141542696&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0141542696&partnerID=8YFLogxK

U2 - 10.1161/01.CIR.0000091254.73351.D6

DO - 10.1161/01.CIR.0000091254.73351.D6

M3 - Article

VL - 108

SP - 1295

EP - 1298

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 11

ER -