Intravascular ultrasound findings after excimer laser coronary angioplasty

✍ Scribed by Mintz, Gary S. ;Kovach, Julie A. ;Pichard, Augusto D. ;Kent, Kenneth M. ;Popma, Jeffrey J. ;Satler, Lowell F. ;Griffin, Jennifer ;Leon, Martin B.

• Publisher: John Wiley and Sons
• Year: 1996
• Tongue: English
• Weight: 612 KB
• Volume: 37
• Category: Article
• ISSN: 0098-6569
• DOI: 10.1002/(sici)1097-0304(199602)37:2<113::aid-ccd1>3.0.co;2-g

✦ Synopsis

lntravascular ultrasound (IVUS) was used to study 104 lesions in 98 patients after excimer laser coronary angioplasty (ELCA). Lesion site external elastic membrane (EEM) and lumen cross-sectional areas (CSA) were measured; plaque + media (P + M = EEMlumen) CSA and percentage of cross-sectional narrowing (CSN = P + M CSNEEM CSA)

were calculated; and the results were compared to a reference site. The lumen CSA (2.6 -c 1 .O mm2) averaged 24% larger than the cross-sectional area of the largest laser catheter used, and 64 lesions (62%) fit the definition of arterial expansion (lesion EEM CSA > reference site EEM CSA). The residual percentage of cross-sectional narrowing averaged 83.8 2 8.8%. Dissections were present in 44% of lesions, and were more common in lesions with superficial calcium (59%) than in lesions with only deep calcium (31%) or no calcium (20%, P = 0.0102). Dissections of superficial calcified plaque had an unusual "shattered" or "fragmented" appearance. These findings suggest that excimer laser angioplasty causes forced vessel expansion with dissection, but limited atheroablation.