Modifications of Minimal Luminal Diameter During the 24 Hours
Modifications of Minimal Luminal Diameter During the 24 Hours
The early renarrowing after percutaneous coronary interventions (PCI) for in-stent restenosis (ISR) is a phenomenon that has received little investigation. Therefore, we assessed the angiographic minimal luminal diameter (MLD) before, immediately after, and 24 hours after the procedure in 30 ISR's treated with balloon angioplasty (BA) or rotational atherectomy (RA). The MLD was 0.68 ± 0.48 mm at baseline, 2.42 ± 0.38 mm after the procedure, and 2.25 ± 0.39 mm at 24 hours (p < 0.0001 for all comparisons). Therefore, a small but significant decrease in MLD between post-procedure and 24 hours, corresponding to an early loss of 0.18 ± 0.16 mm, was evident. The early loss was not significantly different in ISR's treated with BA or RA (0.15 ± 0.16 mm and 0.20 ± 0.16 mm, respectively). No significant correlation between early loss and lesion length, diameter stenosis, reference diameter, and acute gain was found. However, no increase of the 24-hour diameter stenosis to more than 50% was observed. We conclude that the magnitude of early luminal loss after PCI of ISR is small and therefore does not generally constitute a clinical problem.
Luminal renarrowing after percutaneous coronary interventions (PCI) typically occurs several weeks after the procedure. The time course for modification of the luminal geometry after dilatation of in-stent restenosis (ISR) has been less characterized. According to an intravascular ultrasound study, a significant renarrowing after redilatation of ISRs could be detected as early as 42 minutes after the procedure. However, no angiographic data are available on the modifications of luminal dimensions 24 hours after dilatation of an ISR. The aim of this study was to assess the quantitative angiographic parameters 24 hours after percutaneous treatment of ISR and to evaluate the relationship between changes in the minimal luminal diameter (MLD) and several angiographic and procedural characteristics.
The early renarrowing after percutaneous coronary interventions (PCI) for in-stent restenosis (ISR) is a phenomenon that has received little investigation. Therefore, we assessed the angiographic minimal luminal diameter (MLD) before, immediately after, and 24 hours after the procedure in 30 ISR's treated with balloon angioplasty (BA) or rotational atherectomy (RA). The MLD was 0.68 ± 0.48 mm at baseline, 2.42 ± 0.38 mm after the procedure, and 2.25 ± 0.39 mm at 24 hours (p < 0.0001 for all comparisons). Therefore, a small but significant decrease in MLD between post-procedure and 24 hours, corresponding to an early loss of 0.18 ± 0.16 mm, was evident. The early loss was not significantly different in ISR's treated with BA or RA (0.15 ± 0.16 mm and 0.20 ± 0.16 mm, respectively). No significant correlation between early loss and lesion length, diameter stenosis, reference diameter, and acute gain was found. However, no increase of the 24-hour diameter stenosis to more than 50% was observed. We conclude that the magnitude of early luminal loss after PCI of ISR is small and therefore does not generally constitute a clinical problem.
Luminal renarrowing after percutaneous coronary interventions (PCI) typically occurs several weeks after the procedure. The time course for modification of the luminal geometry after dilatation of in-stent restenosis (ISR) has been less characterized. According to an intravascular ultrasound study, a significant renarrowing after redilatation of ISRs could be detected as early as 42 minutes after the procedure. However, no angiographic data are available on the modifications of luminal dimensions 24 hours after dilatation of an ISR. The aim of this study was to assess the quantitative angiographic parameters 24 hours after percutaneous treatment of ISR and to evaluate the relationship between changes in the minimal luminal diameter (MLD) and several angiographic and procedural characteristics.
Source...