Preintervention arterial remodeling as a predictor of intimal hyperplasia after intracoronary stenting: a serial intravascular ultrasound study.

BACKGROUND: The impact of vascular remodeling pattern on intimal hyperplasia (IH) after coronary stenting is unknown. HYPOTHESIS: The preintervention remodeling pattern of the lesion might be associated with IH after the coronary stenting procedure. METHODS: Serial (pre-, post-stent implantation, and follow-up) intravascular ultrasound (IVUS) images were obtained in 58 patients with single-stent implantation (GFX stents in 41 and NIR in 17). The matching IVUS image slices at the preintervention lesion site were selected for serial comparisons. The remodeling index (RI) was defined as lesion/proximal reference external elastic membrane cross-sectional area (CSA) at preintervention lesion site. Adequate remodeling was defined as a RI > 0.95 and inadequate remodeling as a RI < or = 0.95. Vessel stretching, percent vessel stretching, and percent IH CSA, as well as pre- and postintervention IVUS variables were evaluated according to the remodeling pattern. RESULTS: The percent IH CSA was 31% in adequate remodeling (n = 29, mean RI = 1.05) and 41% in inadequate remodeling (n = 29, mean RI = 0.88) (p = 0.049). Percent vessel stretching was 15% in adequate remodeling and 22% in inadequate remodeling (p = 0.007). The RI inversely correlated with percent vessel stretching (r = -0.435, p = 0.001). CONCLUSIONS: Compared with preintervention adequate remodeling, inadequate remodeling was associated with increased percent IH CSA, which might be related with more vessel stretching.