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Zou Y, Tong Q, Wang X, Jiang C, Dai Y, Zhao Y, Cheng J. Impact of plaque and luminal morphology in balloon angioplasty of the femoropopliteal artery: an intravascular ultrasound analysis. Front Cardiovasc Med 2023; 10:1145030. [PMID: 37378394 PMCID: PMC10291324 DOI: 10.3389/fcvm.2023.1145030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
Objective To assess the effect of plaque and luminal morphologies in balloon angioplasty of femoropopliteal lesions using intravascular ultrasound (IVUS). Methods This retrospective, observational study analyzed 836 cross-sectional images using IVUS, from 35 femoropopliteal arteries of patients who underwent endovascular treatment between September 2020 and February 2022. Pre- and post-balloon angioplasty images were matched per 5 mm. Post-balloon angioplasty images were grouped into successful (n = 345) and unsuccessful (n = 491) groups. Plaque and luminal morphologies (such as severity of calcification, vascular remodeling, and plaque eccentricity) were extracted before the balloon angioplasty procedure to identify the predictors of unsuccessful balloon angioplasty. Additionally, 103 images with severe dissection were analyzed using IVUS and angiography. Results In univariate analyses, the predictive factors for unsuccessful balloon angioplasty were vascular remodeling (p < .001), plaque burden (p < .001), lumen eccentricity (p < .001), and balloon/vessel ratio (p = .01). Predictive factors for severe dissections were the guidewire route (p < .001) and balloon/vessel ratio (p = .04). In multivariate analysis, the predictive factors for unsuccessful balloon angioplasty included lumen eccentricity (odds ratio [OR]: 3.99, 95% confidence interval [CI]: 1.28-12.68, p = .02) and plaque burden (OR: 1.03, 95% CI: 1.02-1.04; p < .001). For severe dissections, the independent risk factor was an eccentric guidewire route (OR: 2.10, 95% CI: 1.22-3.65, p = .01). Conclusion High plaque burden and luminal eccentricity were risk factors for failed femoropopliteal artery balloon angioplasty. Additionally, eccentric guidewire routes predicted severe dissection.
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Affiliation(s)
- Yuchi Zou
- Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qiang Tong
- Department of Endocrinology, The Second Affiliated Hospital of Army Medical University, Choingqing, China
| | - Xuehu Wang
- Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chuli Jiang
- Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuanbin Dai
- Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yu Zhao
- Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jun Cheng
- Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Rahman N, Ullah I, Adnan G, Khan MA, Farhad A, Shah I, Abidi J. Clinical Outcomes and Prevalence of Intravascular Ultrasound Use at a Tertiary Care Hospital in a South Asian Country. J Clin Imaging Sci 2021; 11:42. [PMID: 34513206 PMCID: PMC8422435 DOI: 10.25259/jcis_93_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 07/16/2021] [Indexed: 11/04/2022] Open
Abstract
Objectives: Intravascular ultrasound (IVUS) plays a pivotal role in the current era of coronary interventions. We aimed to determine the prevalence of IVUS use and clinical outcomes of IVUS-guided percutaneous treatment of coronary arteries lesions in a South Asian country. Material and Methods: It is a retrospective observational study, a total of 134 consecutive patients having done IVUS, was enrolled from January 2013 to March 2020 at a single center. Results: Out of 134 patients, 97 (72.4%) were male with a mean age of 63.1 ± 12.9 years. The prevalence of IVUS in our center was 3.0%. The most frequent comorbidity observed was dyslipidemia, n = 111 (82.8%). Non-ST-elevation myocardial infarction, n = 50 (37.3%), was the common mode of presentation. On coronary angiogram, the left main (LM) disease was found in n = 46 (34.3%), however, single-vessel disease, n = 51 (38.1%), was most commonly noted. IVUS utilization was higher in the left anterior descending, n = 94 (70.1%), followed by LM, n = 46 (34.3%). The LM mean minimal luminal area was 6.0 ± 2.6 mm2 and minimal luminal diameter was 4.53 mm ± 0.6 (mean). The coronary artery dissection was noted in n = 15 (11.2%). The mean duration of follow-up in our study was 40.3 ± 30.1 months. Major adverse cardiac events (MACEs) were recorded in n = 13 (9.7%), which included heart failure, n = 4 (3%). Cardiovascular death and target vessel revascularization occurred in n = 3 (2.2%). Conclusion: IVUS results in a significant decrease in MACE. Our data might support the broader use of IVUS in both developed and in our part of the world.
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Affiliation(s)
- Nasir Rahman
- Department of Medicine, Aga Khan University Hospital, Karachi, Sindh, Pakistan
| | - Ihsan Ullah
- Department of Medicine, Aga Khan University Hospital, Karachi, Sindh, Pakistan
| | - Ghufran Adnan
- Department of Medicine, Aga Khan University Hospital, Karachi, Sindh, Pakistan
| | - Maria Ali Khan
- Department of Medicine, Aga Khan University Hospital, Karachi, Sindh, Pakistan
| | - Awais Farhad
- Department of Medicine, Aga Khan University Hospital, Karachi, Sindh, Pakistan
| | - Izat Shah
- Department of Medicine, Aga Khan University Hospital, Karachi, Sindh, Pakistan
| | - Jabir Abidi
- Department of Medicine, Aga Khan University Hospital, Karachi, Sindh, Pakistan
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Russo RJ, Silva PD, Teirstein PS, Attubato MJ, Davidson CJ, DeFranco AC, Fitzgerald PJ, Goldberg SL, Hermiller JB, Leon MB, Ling FS, Lucisano JE, Schatz RA, Wong SC, Weissman NJ, Zientek DM. A Randomized Controlled Trial of Angiography Versus Intravascular Ultrasound-Directed Bare-Metal Coronary Stent Placement (The AVID Trial). Circ Cardiovasc Interv 2009; 2:113-23. [DOI: 10.1161/circinterventions.108.778647] [Citation(s) in RCA: 112] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Robert J. Russo
- From the Division of Cardiovascular Diseases (R.J.R, P.D.S., P.S.T, J.E.L., R.A.S.), Scripps Clinic, La Jolla, Calif; New York University Medical Center (M.J.A.), New York, NY; Northwestern University Feinberg School of Medicine (C.J.D.), Chicago, Ill; Comprehensive Cardiovascular Care Group (A.C.D), Milwaukee, Wis; Stanford University (P.J.F.), Palo Alto, Calif; University of Washington Medical Center (S.L.G.), Seattle, Wash; St. Vincent Hospital (J.B.H.), Indianapolis, Ind; Columbia University (M
| | - Patricia D. Silva
- From the Division of Cardiovascular Diseases (R.J.R, P.D.S., P.S.T, J.E.L., R.A.S.), Scripps Clinic, La Jolla, Calif; New York University Medical Center (M.J.A.), New York, NY; Northwestern University Feinberg School of Medicine (C.J.D.), Chicago, Ill; Comprehensive Cardiovascular Care Group (A.C.D), Milwaukee, Wis; Stanford University (P.J.F.), Palo Alto, Calif; University of Washington Medical Center (S.L.G.), Seattle, Wash; St. Vincent Hospital (J.B.H.), Indianapolis, Ind; Columbia University (M
| | - Paul S. Teirstein
- From the Division of Cardiovascular Diseases (R.J.R, P.D.S., P.S.T, J.E.L., R.A.S.), Scripps Clinic, La Jolla, Calif; New York University Medical Center (M.J.A.), New York, NY; Northwestern University Feinberg School of Medicine (C.J.D.), Chicago, Ill; Comprehensive Cardiovascular Care Group (A.C.D), Milwaukee, Wis; Stanford University (P.J.F.), Palo Alto, Calif; University of Washington Medical Center (S.L.G.), Seattle, Wash; St. Vincent Hospital (J.B.H.), Indianapolis, Ind; Columbia University (M
| | - Michael J. Attubato
- From the Division of Cardiovascular Diseases (R.J.R, P.D.S., P.S.T, J.E.L., R.A.S.), Scripps Clinic, La Jolla, Calif; New York University Medical Center (M.J.A.), New York, NY; Northwestern University Feinberg School of Medicine (C.J.D.), Chicago, Ill; Comprehensive Cardiovascular Care Group (A.C.D), Milwaukee, Wis; Stanford University (P.J.F.), Palo Alto, Calif; University of Washington Medical Center (S.L.G.), Seattle, Wash; St. Vincent Hospital (J.B.H.), Indianapolis, Ind; Columbia University (M
| | - Charles J. Davidson
- From the Division of Cardiovascular Diseases (R.J.R, P.D.S., P.S.T, J.E.L., R.A.S.), Scripps Clinic, La Jolla, Calif; New York University Medical Center (M.J.A.), New York, NY; Northwestern University Feinberg School of Medicine (C.J.D.), Chicago, Ill; Comprehensive Cardiovascular Care Group (A.C.D), Milwaukee, Wis; Stanford University (P.J.F.), Palo Alto, Calif; University of Washington Medical Center (S.L.G.), Seattle, Wash; St. Vincent Hospital (J.B.H.), Indianapolis, Ind; Columbia University (M
| | - Anthony C. DeFranco
- From the Division of Cardiovascular Diseases (R.J.R, P.D.S., P.S.T, J.E.L., R.A.S.), Scripps Clinic, La Jolla, Calif; New York University Medical Center (M.J.A.), New York, NY; Northwestern University Feinberg School of Medicine (C.J.D.), Chicago, Ill; Comprehensive Cardiovascular Care Group (A.C.D), Milwaukee, Wis; Stanford University (P.J.F.), Palo Alto, Calif; University of Washington Medical Center (S.L.G.), Seattle, Wash; St. Vincent Hospital (J.B.H.), Indianapolis, Ind; Columbia University (M
| | - Peter J. Fitzgerald
- From the Division of Cardiovascular Diseases (R.J.R, P.D.S., P.S.T, J.E.L., R.A.S.), Scripps Clinic, La Jolla, Calif; New York University Medical Center (M.J.A.), New York, NY; Northwestern University Feinberg School of Medicine (C.J.D.), Chicago, Ill; Comprehensive Cardiovascular Care Group (A.C.D), Milwaukee, Wis; Stanford University (P.J.F.), Palo Alto, Calif; University of Washington Medical Center (S.L.G.), Seattle, Wash; St. Vincent Hospital (J.B.H.), Indianapolis, Ind; Columbia University (M
| | - Steven L. Goldberg
- From the Division of Cardiovascular Diseases (R.J.R, P.D.S., P.S.T, J.E.L., R.A.S.), Scripps Clinic, La Jolla, Calif; New York University Medical Center (M.J.A.), New York, NY; Northwestern University Feinberg School of Medicine (C.J.D.), Chicago, Ill; Comprehensive Cardiovascular Care Group (A.C.D), Milwaukee, Wis; Stanford University (P.J.F.), Palo Alto, Calif; University of Washington Medical Center (S.L.G.), Seattle, Wash; St. Vincent Hospital (J.B.H.), Indianapolis, Ind; Columbia University (M
| | - James B. Hermiller
- From the Division of Cardiovascular Diseases (R.J.R, P.D.S., P.S.T, J.E.L., R.A.S.), Scripps Clinic, La Jolla, Calif; New York University Medical Center (M.J.A.), New York, NY; Northwestern University Feinberg School of Medicine (C.J.D.), Chicago, Ill; Comprehensive Cardiovascular Care Group (A.C.D), Milwaukee, Wis; Stanford University (P.J.F.), Palo Alto, Calif; University of Washington Medical Center (S.L.G.), Seattle, Wash; St. Vincent Hospital (J.B.H.), Indianapolis, Ind; Columbia University (M
| | - Martin B. Leon
- From the Division of Cardiovascular Diseases (R.J.R, P.D.S., P.S.T, J.E.L., R.A.S.), Scripps Clinic, La Jolla, Calif; New York University Medical Center (M.J.A.), New York, NY; Northwestern University Feinberg School of Medicine (C.J.D.), Chicago, Ill; Comprehensive Cardiovascular Care Group (A.C.D), Milwaukee, Wis; Stanford University (P.J.F.), Palo Alto, Calif; University of Washington Medical Center (S.L.G.), Seattle, Wash; St. Vincent Hospital (J.B.H.), Indianapolis, Ind; Columbia University (M
| | - Frederick S. Ling
- From the Division of Cardiovascular Diseases (R.J.R, P.D.S., P.S.T, J.E.L., R.A.S.), Scripps Clinic, La Jolla, Calif; New York University Medical Center (M.J.A.), New York, NY; Northwestern University Feinberg School of Medicine (C.J.D.), Chicago, Ill; Comprehensive Cardiovascular Care Group (A.C.D), Milwaukee, Wis; Stanford University (P.J.F.), Palo Alto, Calif; University of Washington Medical Center (S.L.G.), Seattle, Wash; St. Vincent Hospital (J.B.H.), Indianapolis, Ind; Columbia University (M
| | - Jennifer E. Lucisano
- From the Division of Cardiovascular Diseases (R.J.R, P.D.S., P.S.T, J.E.L., R.A.S.), Scripps Clinic, La Jolla, Calif; New York University Medical Center (M.J.A.), New York, NY; Northwestern University Feinberg School of Medicine (C.J.D.), Chicago, Ill; Comprehensive Cardiovascular Care Group (A.C.D), Milwaukee, Wis; Stanford University (P.J.F.), Palo Alto, Calif; University of Washington Medical Center (S.L.G.), Seattle, Wash; St. Vincent Hospital (J.B.H.), Indianapolis, Ind; Columbia University (M
| | - Richard A. Schatz
- From the Division of Cardiovascular Diseases (R.J.R, P.D.S., P.S.T, J.E.L., R.A.S.), Scripps Clinic, La Jolla, Calif; New York University Medical Center (M.J.A.), New York, NY; Northwestern University Feinberg School of Medicine (C.J.D.), Chicago, Ill; Comprehensive Cardiovascular Care Group (A.C.D), Milwaukee, Wis; Stanford University (P.J.F.), Palo Alto, Calif; University of Washington Medical Center (S.L.G.), Seattle, Wash; St. Vincent Hospital (J.B.H.), Indianapolis, Ind; Columbia University (M
| | - S. Chiu Wong
- From the Division of Cardiovascular Diseases (R.J.R, P.D.S., P.S.T, J.E.L., R.A.S.), Scripps Clinic, La Jolla, Calif; New York University Medical Center (M.J.A.), New York, NY; Northwestern University Feinberg School of Medicine (C.J.D.), Chicago, Ill; Comprehensive Cardiovascular Care Group (A.C.D), Milwaukee, Wis; Stanford University (P.J.F.), Palo Alto, Calif; University of Washington Medical Center (S.L.G.), Seattle, Wash; St. Vincent Hospital (J.B.H.), Indianapolis, Ind; Columbia University (M
| | - Neil J. Weissman
- From the Division of Cardiovascular Diseases (R.J.R, P.D.S., P.S.T, J.E.L., R.A.S.), Scripps Clinic, La Jolla, Calif; New York University Medical Center (M.J.A.), New York, NY; Northwestern University Feinberg School of Medicine (C.J.D.), Chicago, Ill; Comprehensive Cardiovascular Care Group (A.C.D), Milwaukee, Wis; Stanford University (P.J.F.), Palo Alto, Calif; University of Washington Medical Center (S.L.G.), Seattle, Wash; St. Vincent Hospital (J.B.H.), Indianapolis, Ind; Columbia University (M
| | - David M. Zientek
- From the Division of Cardiovascular Diseases (R.J.R, P.D.S., P.S.T, J.E.L., R.A.S.), Scripps Clinic, La Jolla, Calif; New York University Medical Center (M.J.A.), New York, NY; Northwestern University Feinberg School of Medicine (C.J.D.), Chicago, Ill; Comprehensive Cardiovascular Care Group (A.C.D), Milwaukee, Wis; Stanford University (P.J.F.), Palo Alto, Calif; University of Washington Medical Center (S.L.G.), Seattle, Wash; St. Vincent Hospital (J.B.H.), Indianapolis, Ind; Columbia University (M
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