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.