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Serial Intravascular Ultrasound Evidence for Arterial Remodeling as a Mechanism of Restenosis Following Interventional Coronary Procedures

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Arterial Remodeling: A Critical Factor in Restenosis

Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 198))

Abstract

Restenosis occurs within the first 6 months after 30% to 50% of transcatheter procedures; it remains the major limitation to percutaneous coronary revascularization (1, 2). The restenotic lesion has been thought to be a proliferative lesion in which an exaggeration of the normal reparative processes following angioplasty-induced local vessel trauma leads to proliferation of both cellular and matrix components causing an increased tissue mass and restenosis (3–7). As the understanding of this process has advanced, attempts have been made to attack restenosis by interfering with this cascade. Although the results in animal models have been impressive, pharmacologic trials using anti-proliferative agents in humans have been strikingly ineffective in humans (8).

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References

  1. Holmes DR, Vlietstra RE, Smith H, Vetrovec G, Kent KM, Cowley MJ, Faxon DP, Gruentzig AR, Kelsey SF, Detre KM, Van Raden MJ, Mock MB. Restenosis after percutaneous transluminal coronary angioplasty (PTCA): a report from the PTCA Registry of the NHLBI. Am J Cardiol 1984; 53:77C–81C.

    Article  PubMed  Google Scholar 

  2. Detre K, Holubkov R, Kelsey S, Cowley M, Kent K, Williams D, Myler R, Faxon D, Holmes D, Bourassa M, Block P, Gosselin A, Bentivoglio L, Leatherman L, Dorros G, King SB III, Galichia J, Al-Bassam M, Leon M, Robertson T, Passamani E. Percutaneous transluminal coronary angioplasty in 1985–1986 and 1977–1981. The National Heart, Lung, and Blood Institute Registry. N Engl J Med 1988; 318:265–270.

    Article  PubMed  CAS  Google Scholar 

  3. Califf RM, Fortin DF, Frid DJ, Harlan WR III, Ohman EM, Bengtson JR, Nelson CL, Tcheng JE, Mark DB, Stack RS. Restenosis after coronary angioplasty: An overview. J Am Coll Cardiol 1991; 17:2B–13B.

    Article  PubMed  CAS  Google Scholar 

  4. Forrester JS, Fishbein M, Helfant R, Fagin J. A paradigm for restenosis based on cell biology: Clues for the development of new preventive therapies. J Am Coll Cardiol 1991; 17:758–769.

    Article  PubMed  CAS  Google Scholar 

  5. Lee PC, Gibbons GH, Dzau VJ. Cellular and molecular mechanisms of coronary artery restenosis. Coronary Artery Dis 1993; 4:254–259.

    Article  CAS  Google Scholar 

  6. McBride W, Lange RA, Hillis LD. Restenosis after successful coronary angioplasty, pathophysiology and prevention. N Engl J Med 1988; 318:1734–1737.

    Article  PubMed  CAS  Google Scholar 

  7. Schwartz RS, Holmes DR Jr, Topol EJ. The restenosis paradigm revisited: An alternative proposal for cellular mechanisms. J Am Coll Cardiol 1992; 20:1284–1293.

    Article  PubMed  CAS  Google Scholar 

  8. Franklin SM, Faxon DP. Pharmacologic prevention of restenosis after coronary angioplasty: review of randomized clinical trials. Coronary Artery Dis 1993; 4:232–242.

    Article  CAS  Google Scholar 

  9. O’Brien ER, Alpres CE, Stewart DK, Ferguson M, Tran N, Gordon D, Benditt EP, Hinohara T, Simpson JB, Schwarts SM. Proliferation in primary and restenotic coronary atherectomy specimens: implications for antiproliferative therapy. Circ Res 1993; 73:223–231.

    Article  PubMed  Google Scholar 

  10. Waller BF, Pinkerton CA, Orr CM, Slack JD, VanTassel JW, Peters T. Morphological observations late (>30 days) after clinically successful coronary balloon angioplasty. Circulation 1991;83: I-28–41.

    Google Scholar 

  11. Nobuyoshi M, Kimura T, Ohishi H, Horiuchi H, Nosaka H, Hamasaki N, Yokoi H, Kim K. Restenosis after percutaneous transluminal coronary angioplasty. Pathologic observations in 20 patients. J Am Coll Cardiol 1991;17:433–439.

    Article  PubMed  CAS  Google Scholar 

  12. Farb A, Virmani R, Atkinson JB, Kolodgie FD. Plaque morphology and pathologic changes in arteries from patients dying after coronary balloon angioplasty. J Am Call Cardiol 1990; 16:1421–1429.

    Article  CAS  Google Scholar 

  13. Currier JW, Faxon DP. Restenosis after percutaneous translumina1 coronary angioplasty: have we been aiming at the wrong target? J Am Coll Cardiol 1995; 25:516–520.

    Article  PubMed  CAS  Google Scholar 

  14. Post MJ, Borst C, Kuntz RE. The relative importance of arterial remodeling compared with intimaI hyperplasia in lumen renarrowing after balloon angioplasty. Circulation 1994; 89:2816–2821.

    Article  PubMed  CAS  Google Scholar 

  15. Lafont A, Guzman L, Whitlow P, Goormastic M, Comhill J, Chisholm G. Restenosis after experimental angioplasty: Intimal, medial, and adventitial changes associated with constrictive remodeling. Circ Res 1995; 76:996–1002.

    Article  PubMed  CAS  Google Scholar 

  16. Kakuta T, Currier JW, Haudenschild CC, Ryan TJ, Faxon DP. Differences in compensatory vessel enlargement, not intimal proliferation, account for restenosis after angioplasty in the hypercholesterolemic rabbit. Circulation 1994; 89:2809–2815.

    Article  PubMed  CAS  Google Scholar 

  17. Glagov S, Weisenberg E, Zarins CK, Stankunacicius K, Kolettis GJ. Compensatory enlargement of various human atherosclerotic arteries. N Engl J Med 1987; 316:1371–1375.

    Article  PubMed  CAS  Google Scholar 

  18. Zarins CK, Weisenberg E, Kolettis G, Stankunavicius R, Glagov S. Differential enlargement of artery segments in response to enlarging atherosclerotic plaques. J Vasc Surg 1988; 7:386–394.

    PubMed  CAS  Google Scholar 

  19. Pasterkamp G, Wensing PJW, Post MJ, Hillen B, Mali WPTM, Borst C. Paradoxical arterial wall shrinkage may contribute to luminal narrowing of human atheroscleriotc femoral arteries. Circulation 1995; 91:1444–1449.

    Article  PubMed  CAS  Google Scholar 

  20. Mintz GS, Griffin J, Hong MK, Bucher TA, Kehoe MK, Pichard AD. Focal arterial contraction is important in the development of coronary artery stenoses in patients with chronic stable angina. Circulation 1995;92:I–400.

    Google Scholar 

  21. Fischman DL, Leon MB, Baim DS, Schatz RA, Savage MP, Penn I, Detre K, Veltri L, Ricci D, Nobuyoshi N, Cleman M, Heuser R, Almond D, Teirstein PS, Fish RD, Colombo A, Brinker J, Moses J, Shaknovitch A, Hirshfeld J, Bailey S, Ellis S, Rake R, Goldberg S. A randomized comparison of coronary stent placement and balloon angioplasty in the treatment of coronary artery disease. N Engl J Med 1994; 331:496–501.

    Article  PubMed  CAS  Google Scholar 

  22. Serruys P, De Jaegere P, Kiemeneij F, Macaya C, Rutsch W, Heyndrickx G, Emanuelsson H, Marco J, Legrand V, Materne P, Belardi J, Sigwart U, Colombo A, Goy J J, van den Heuvel P, Delcan J, Morel M-A. A comparison of balloon-expandable-stent implantation with balloon angioplasty in patients with coronary artery disease. N Engl J Med 1994; 331:490–495.

    Article  Google Scholar 

  23. Mintz GS, Pichard AD, Kent KM, Satler LF, Popma JJ, Wong SC, Painter JA, Leon MB Endovascular stents reduce restenosis by eliminating geometric arterial remodeling: A serial intravascular ultrasound study. J Am Coll Cardiol 1995;25:36A

    Google Scholar 

  24. Strauss BH, Umans VA, van Suylen R-J, de Feyter PJ, Marco J, Robertson GC, Renkin J, Heyndrickx G, Vuzevski VD, Bosman FT, Serruys PW. Directional atherectomy for treatment of restenosis within coronary stents: Clinical, angiographic and histologic results. J Am Coll Cardiol 1992; 20:1465–1473.

    Article  PubMed  CAS  Google Scholar 

  25. Matar FA, Mintz GS, Farb A, Douek P, Pichard AD, Kent KM, Satler LF, Popma JJ, Keller MB, Pinnow E, Merritt AJ, Lindsay J Jr, Leon MB. The contribution of tissue removal to lumen improvement after directional coronary atherectomy. Am J Cardiol 1994; 74:647–650.

    Article  PubMed  CAS  Google Scholar 

  26. Kovach JA, Mintz GS, Pichard AD, Kent KM, Popma JJ, Satler LF, Leon MB. Sequential intravascular ultrasound characterization of the mechanisms of rotational atherectomy and adjunct balloon angioplasty. J Am Coll Cardiol 1993; 22:1024–1032.

    Article  PubMed  CAS  Google Scholar 

  27. Mintz GS, Kovach JA, Javier SP, Pichard AD, Kent KM, Popma JJ, Salter LF, Leon MB. Mechanisms of lumen enlargement after excimer laser coronary angioplasty: An intravascular ultrasound study. Circulation 1995;92:3408–3414.

    Article  PubMed  CAS  Google Scholar 

  28. Mintz GS, Pichard AD, Popma JJ, Kent KM, Satler LF, Leon MB. Preliminary experience with adjunct directional coronary atherectomy following high-speed rotational atherectomy in the treatment of calcific coronary artery disease. Am J Cardiol 1993; 71:799–804.

    Article  PubMed  CAS  Google Scholar 

  29. Mintz GS, Pichard AD, Kent KM, Satler LF, Popma JJ, Leon MB. Axial plaque redistribution as a mechanism of percutaneous transluorinal coronary angioplasty. Am J Cardiol 1996;77:427–430.

    Article  PubMed  CAS  Google Scholar 

  30. Hodgson JMcB, Graham SP, Sarakus AD, Dame SG, Stephens DN, Dhillon PS, Brands D, Sheehan H, Eberle MJ. Clinical percutaneous imaging of coronary anatomy using an over-the-wire ultrasound catheter system. In J Cardiac Imaging 1989; 4:186–193.

    Google Scholar 

  31. Gussenhoven EJ, Essed CE, Lancee CT, Mastik F, Frietman P, van Egmond FC, Reiber J, Bosch H, van Urk H, Roelandt J, Bom N. Arterial wall characteristics determined by intravascular ultrasound imaging: An in vitro study. J Am Coll Cardiol 1989; 14:947–952.

    Article  PubMed  CAS  Google Scholar 

  32. Nishimura RA, Edwards WD, Warnes CA, Reeder GS, Holmes DR Jr, Tajik M, Yock PG. Intravascular ultrasound imaging: in vitro validation and pathologic correlation. J Am Coll Cardiol 1990; 16:145–154.

    Article  PubMed  CAS  Google Scholar 

  33. Potkin BN, Bartorelli AL, Gessert JM, Neville RF, Almagor Y, Roberts WC, Leon MB. Coronary artery imaging with intravascular high-frequency ultrasound. Circulation 1990; 81:1575–1585.

    Article  PubMed  CAS  Google Scholar 

  34. Nissen SE, Grines CL, Gurley JC, Sublett K, Haynie D, Diaz C, Booth DC, DeMaria AN. Application of a new phased-array ultrasound imaging catheter in the assessment of vascular dimensions. In vivo comparison to cineangiography. Circulation 1990; 81:660–666.

    Article  PubMed  CAS  Google Scholar 

  35. Tobis JM, Mallery JA, Gessert J, Griffith J, Mahon D, Bessen M, Moriuchi M, McLeay L, McRae M, Henry WL. Intravascular ultrasound cross-sectional arterial imaging before and after balloon angioplasty in vitro. Circulation 1989; 80:873–882.

    Article  PubMed  CAS  Google Scholar 

  36. Mallery JA, Tobis JM, Griffith J, Gessert J, McRae M, Moussabeck O, Bessen M, Moriuchi M, Henry WL. Assessment of normal and atherosclerotic arterial wall thickness with an intravascular ultrasound imaging catheter. Am Heart J 1990; 119:1392–1400.

    Article  PubMed  CAS  Google Scholar 

  37. Mintz GS, Popma JJ, Pichard AD, Kent KM, Satler LF, Wong SC, Hong MK, Kovach JA, Leon MB. Arterial remodeling after coronary angioplasty: A serial intravascular ultrasound study. Circulation 1996; 94:35–43

    Article  PubMed  CAS  Google Scholar 

  38. Fuessl RT, Mintz GS, Pichard AD, Kent KM, Satler LF, Popma JJ, Leon MB. In vivo validation of intravascular ultrasound length measurements using a motorized transducer pullback device. Am J Cardiol (in press).

    Google Scholar 

  39. Ebel R L. Estimation of the reliability of ratings. Psychometrika 1951; 16:407–424.

    Article  Google Scholar 

  40. Mintz GS, Fitzgerald PF, Kuntz RE, Simonton CA, Bersin RM, Yock PG, Baim DM, and Leon MB. Lesion site and reference segment remodeling after directional coronary atherectomy: An analysis from the optimal atherectomy restenosis study. Circulation 1995;92:1–93.

    Article  Google Scholar 

  41. Popma JJ, Mintz GS, Baim DS, Kuntz RE, Simonton C, Hinohara T, Burwell N, Schnabel JS, Desai A, Zhang Y, Leon MB. Reference vessel remodeling after optimal directional coronary atherectomy. J Inv Cardiol 1996;8:34.

    Google Scholar 

  42. Kimura T, Kaburagi S, Tashima Y, Nobuyoshi M, Mintz GS, Popma JJ. Geometric remodeling and intimai regrowth as mechanisms of restenosis: Observations from Serial Ultrasound analysis of REstenosis (SURE) Trial. Circulation 1995;92:1–76.

    Article  Google Scholar 

  43. Libby P, Schwartz D, Brogi E, Tanaka H, Clinton SK. A cascade model for restenosis: A special case of atherosclerosis progression. Circulation 1992; 86:III-47–III-52.

    Article  Google Scholar 

  44. Glagov S. Intimal hyperplasia, vascular remodeling, and the restenosis problem. Circulation 1994; 89:2888–2891.

    Article  PubMed  CAS  Google Scholar 

  45. Isner JM. Vascular remodeling. Honey, I think I shrunk the artery. Circulation 1994; 89:2937–2941.

    Article  PubMed  CAS  Google Scholar 

  46. Brott BC, Labinaz M, Culp SC, Fortin DF, Virmani R, Phillips HR, Stack RS. Vessel remodeling after angioplasty: Comparative anatomic studies. J Am Coll Cardiol 1994; 1994:138A.

    Google Scholar 

  47. Isner JM, Donaldson RF, Fortin H, Tischler A, Clarke RH. Attenuation of the media of coronary arteries in advanced atherosclerosis. Am J Cardiol 1986; 58:937–939.

    Article  PubMed  CAS  Google Scholar 

  48. Mintz GS, Popma JJ, Pichard AD, Kent KM, Satler LF, Chuang YC, Griffin J, Leon MB. Intravascular ultrasound predictors of restenosis following percutaneous transcatheter coronary revascularization. J Am Coll Cardiol 1996;27:1678–87.

    Article  PubMed  CAS  Google Scholar 

  49. The GUIDE Trial Investigators. IVUS-determined predictors of restenosis in PTCA and DCA: An interim report from the GUIDE Trial, Phase II. Circulation 1994;90:I–23.

    Google Scholar 

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Author information

Authors and Affiliations

  1. lntravascular Ultrasound Imaging and Cardiac Catheterization Laboratories of Washington Hospital Center, Washington, USA

    Gary S. Mintz M.D., Jeffrey J. Popma M.D., Augusto D. Pichard M.D., Kenneth M. Kent M.D. Ph.D., Lowell F. Satler M.D. & Martin B. Leon M.D.

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  1. Gary S. Mintz M.D.
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  2. Jeffrey J. Popma M.D.
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  3. Augusto D. Pichard M.D.
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  4. Kenneth M. Kent M.D. Ph.D.
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  5. Lowell F. Satler M.D.
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  6. Martin B. Leon M.D.
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Editor information

Editors and Affiliations

  1. Necker University, Paris, France

    Antoine Lafont

  2. Cleveland Clinic Foundation, Cleveland, Ohio, USA

    Eric J. Topol

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Mintz, G.S., Popma, J.J., Pichard, A.D., Kent, K.M., Satler, L.F., Leon, M.B. (1997). Serial Intravascular Ultrasound Evidence for Arterial Remodeling as a Mechanism of Restenosis Following Interventional Coronary Procedures. In: Lafont, A., Topol, E.J. (eds) Arterial Remodeling: A Critical Factor in Restenosis. Developments in Cardiovascular Medicine, vol 198. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-6079-1_7

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  • DOI: https://doi.org/10.1007/978-1-4615-6079-1_7

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-7785-6

  • Online ISBN: 978-1-4615-6079-1

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