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Title: Mechanisms and predictors of carotid artery stent restenosis: a serial intravascular ultrasound study.
Austin Authors: Clark, David J ;Lessio, Sara;O'Donoghue, Margaret;Tsalamandris, Con;Schainfeld, Robert;Rosenfield, Kenneth
Affiliation: Department of Cardiology, Austin Hospital, Melbourne, Australia
Issue Date: 30-May-2006
Publication information: Journal of the American College of Cardiology 2006; 47(12): 2390-6
Abstract: The aim of this study was to determine the mechanisms and predictors of carotid artery restenosis after carotid artery stenting (CAS) using serial intravascular ultrasound (IVUS) imaging.Carotid artery stenting is increasingly used to treat high-grade obstructive carotid disease, but our knowledge of carotid in-stent restenosis and remodeling remains limited.Post-procedural and 6-month (median 6 months) follow-up quantitative carotid angiography and IVUS were performed after self-expanding stent deployment in 50 internal carotid arteries (ICA). The IVUS measurements at multiple designated sites included minimal luminal diameter, lumen area, stent area (SA), and neointimal hyperplasia area (NIH).Late stent enlargement at follow-up was found at all segments, and the percentage increase was greatest at the ICA lesion site (mean +/- SD, 48.9 +/- 35.3%). The NIH, expressed as a percentage of SA, was seen within all segments of the stent and was greatest at the ICA lesion site (37.3 +/- 23.3%). There was a strong positive correlation between the amount of NIH and late stent enlargement (r = 0.64; p < 0.001). Immediate post-procedural minimum ICA SA (r = -0.37; p < 0.01) and stent expansion (r = -0.44; p = 0.001) correlated negatively with the percentage restenotic area at follow-up.Although self-expanding carotid stents generate considerable neointimal hyperplasia, the process is balanced by marked late stent enlargement. Small stent dimensions immediately post-procedure were associated with a higher risk of restenosis.
Gov't Doc #: 16781364
DOI: 10.1016/j.jacc.2006.01.076
Journal: Journal of the American College of Cardiology
Type: Journal Article
Subjects: Aged
Aged, 80 and over
Follow-Up Studies
Middle Aged
Ultrasonography, Interventional
Appears in Collections:Journal articles

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