Arterial remodeling influences the development of intimal hyperplasia after stent implantation

OBJECTIVES: We examined whether preinterventional arterial remodeling influenced the interventional results after stenting. BACKGROUND: Arterial remodeling is seen in atherosclerotic lesions, and it may play an important role in the early stage of atherosclerosis. METHODS: We examined 113 lesions that underwent elective stenting using tubular slotted stents under intravascular ultrasound guidance. The lesions were divided into three groups - adequate, intermediate and inadequate remodeling group - according to preinterventional arterial remodeling. The patients were subjected to coronary angiography and intravascular ultrasound evaluation on average 6.4 months after stenting. RESULTS: At baseline and immediately after stenting, there were no differences in quantitative angiographic analysis among remodeling groups. However, the plaque cross-sectional area (CSA) in the minimal lumen CSA at preintervention and intimal hyperplasia CSA at follow-up were significantly larger in the adequate remodeling group than in the inadequate remodeling group. The restenosis rate of stenting for the lesions with inadequate arterial remodeling was very low (9.4%). A significant positive correlation was found between preinterventional plaque CSA and intimal hyperplasia CSA at follow-up (r = 0.47, p < 0.0001). Moreover, remodeling index significantly correlated with relative intimal hyperplasia CSA (r = 0.28, p < 0.01). CONCLUSIONS: Preinterventional arterial remodeling influenced the development of intimal hyperplasia after stenting.