Plaque area increase and vascular remodeling contribute to lumen area change after percutaneous transluminal angioplasty of the femoropopliteal artery:

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Presentation transcript:

Plaque area increase and vascular remodeling contribute to lumen area change after percutaneous transluminal angioplasty of the femoropopliteal artery: An intravascular ultrasound study Winnifred van Lankeren, MD, Elma J. Gussenhoven, MD, PhD, Jan Honkoop, Theo Stijnen, MSc, PhD, Hans van Overhagen, MD, PhD, Cees H. A. Wittens, MD, PhD, Steven E. Kranendonk, MD, PhD, Marc R.H.M. van Sambeek, MD, Aad van der Lugt, MD, PhD Journal of Vascular Surgery Volume 29, Issue 3, Pages 430-441 (March 1999) DOI: 10.1016/S0741-5214(99)70271-5 Copyright © 1999 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig 1 Angiograms and corresponding intravascular sonographic cross-sections (levels A, B, C) obtained from patient after percutaneous transluminal angioplasty of femoropopliteal artery (left) and at 6 months follow-up examination (right). The intravascular ultrasound cross-sections are contour-traced off-line for lumen area (inner contour) and vessel area (outer contour). Level A is obtained at the proximal reference site, and levels B and C are obtained at the treated sites. Plaque area increase was seen in all levels; lumen area increase (A and C) and lumen area decrease (B) were determined by type of vessel area change. Media rupture and dissection seen after intervention (B, solid arrow) were not encountered at follow-up examination. At level C, hard lesion (open arrow) was seen both at intervention and at follow-up examination. Note that the guide-wire present in left panels results in dropout of 30 degrees. +, Catheter; calibration, 1 mm. Journal of Vascular Surgery 1999 29, 430-441DOI: (10.1016/S0741-5214(99)70271-5) Copyright © 1999 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig 2 Graph showing plaque and vessel area change assessed with intravascular ultrasound, derived from an individual patient. Note that plaque area increase was combined with wide variation of vessel area change. n, Number of intravascular sonographic cross-sections. Journal of Vascular Surgery 1999 29, 430-441DOI: (10.1016/S0741-5214(99)70271-5) Copyright © 1999 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig 3 Scatter plots of lumen area change versus vessel area change (left panels) and of lumen area change versus plaque area change (right panels) assessed in matched intravascular ultrasound cross-sections obtained at the treated sites and reference sites. SEE, Standard error of the estimate. Journal of Vascular Surgery 1999 29, 430-441DOI: (10.1016/S0741-5214(99)70271-5) Copyright © 1999 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig 4 Scatter plots of lumen area change after percutaneous transluminal angioplasty versus lumen, plaque, and vessel area change at follow-up examination (left panels) and of vessel area change after percutaneous transluminal angioplasty versus lumen, plaque, and vessel area change at follow-up examination (right panels) assessed in matched intravascular ultrasound cross-sections (n = 113) obtained at the treated sites. Δ, Change; LA, lumen area; PLA, plague area; VA, vessel area; FU, follow-up; PTA, percutaneous transluminal angioplasty; SEE, standard error of the estimate. Journal of Vascular Surgery 1999 29, 430-441DOI: (10.1016/S0741-5214(99)70271-5) Copyright © 1999 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions