Effect of balloon angioplasty on femoral artery evaluated with intravascular ultrasound imaging.
- 1 August 1992
- journal article
- abstracts
- Published by Wolters Kluwer Health in Circulation
- Vol. 86 (2) , 483-493
- https://doi.org/10.1161/01.cir.86.2.483
Abstract
BACKGROUND Intravascular ultrasound was used to assess the immediate effect of balloon angioplasty on the superficial femoral artery. METHODS AND RESULTS In 16 consecutive patients, corresponding ultrasonic cross sections (n = 72) before and after balloon angioplasty were qualitatively and quantitatively analyzed. The qualitative data were compared with angiographic findings. Before intervention, the angiographically demonstrated obstructive lesions were confirmed by intravascular ultrasound. Ultrasound enabled discrimination between soft (n = 43) and hard (n = 29) lesions, as well as between eccentric (n = 57) and concentric (n = 15) lesions. After balloon angioplasty, the presence of a dissection assessed angiographically in 14 patients was confirmed by intravascular ultrasound. Additional morphological information provided by ultrasound included plaque rupture in 14 patients and internal lamina rupture in six patients. Quantitative ultrasound data revealed an increase in free lumen area from 9.7 +/- 4.7 to 18.3 +/- 7.0 mm2 (p less than or equal to 0.01), an increase in minimal lumen diameter from 2.8 +/- 0.7 to 3.6 +/- 1.2 mm (p less than or equal to 0.01), and an increase in media-bounded area from 21.7 +/- 5.4 to 28.3 +/- 5.8 mm2 (p less than or equal to 0.01). The lesion area for the majority of cases (n = 32) remained unchanged (13.0 +/- 4.9 mm2 versus 12.9 +/- 4.6 mm2), or the lesion disappeared partially (from 9.1 +/- 0.9 to 4.3 +/- 1.4 mm2, n = 4, p less than or equal to 0.01) or totally (from 10.1 +/- 4.2 to 0 mm2, n = 6). Stretching of the arterial wall was further evidenced by medial thinning from 0.55 +/- 0.19 to 0.34 +/- 0.11 mm (p less than or equal to 0.01). CONCLUSIONS Luminal enlargement by balloon dilatation is achieved primarily by overstretching the arterial wall, with the lesion volume remaining practically unchanged. Overstretching is accompanied almost always by dissection and plaque rupture and occasionally by an internal lamina rupture.Keywords
This publication has 21 references indexed in Scilit:
- Assessment of medial thinning in atherosclerosis by intravascular ultrasoundThe American Journal of Cardiology, 1991
- Ultrasound guided therapeutic catheters: recent developments and clinical resultsThe International Journal of Cardiovascular Imaging, 1991
- Intravascular ultrasound imaging following balloon angioplastyThe International Journal of Cardiovascular Imaging, 1991
- Validation of quantitative analysis of intravascular ultrasound imagesThe International Journal of Cardiovascular Imaging, 1991
- Real-time intravascular ultrasonic imaging before and after balloon angioplastyJournal of Clinical Ultrasound, 1991
- Real-time intravascular ultrasound imaging in humansThe American Journal of Cardiology, 1990
- Intravascular echographic assessment of vessel wall characteristics: a correlation with histologyThe International Journal of Cardiovascular Imaging, 1989
- Mechanism of angioplasty and its relation to restenosisThe American Journal of Cardiology, 1987
- Mechanism of transluminal angioplastyThe American Journal of Cardiology, 1984
- Frequency in nonangioplasty patients of morphologic findings reported in coronary arteries treated with transluminal angioplastyThe American Journal of Cardiology, 1983