Author/Authors :
Sano، نويسنده , , Koichi and Mintz، نويسنده , , Gary S. and Carlier، نويسنده , , Stéphane G. and Fujii، نويسنده , , Kenichi and Yasuda، نويسنده , , Takenori and Kimura، نويسنده , , Masashi and Costa Jr، نويسنده , , Jose Ribamar and Costa، نويسنده , , Ricardo A. and Lui، نويسنده , , Joanna and Weisz، نويسنده , , Giora and Moussa، نويسنده , , Issam and Dangas، نويسنده , , George D. and Mehran، نويسنده , , Roxa، نويسنده ,
Abstract :
Previous studies have reported differences in interventional complication rates that depend on saphenous vein graft (SVG) lesion location. However, little is known about morphologic differences between lesions in different SVG locations. We evaluated preintervention intravascular ultrasound (IVUS) images of 75 de novo SVG lesions (aorto-ostial, n = 15; shaft, n = 60) in 63 patients. IVUS data were measured at the minimal lumen area and at 2 proximal and 2 distal references. Positive remodeling was defined as a lesion site SVG area that was larger than the average of the 2 distal references. Shaft lesions more often contained soft plaque (60.0% vs 26.7%, p = 0.02). Minimal lumen areas were identical (4.5 ± 2.9 vs 4.3 ± 1.5 mm2, p = 0.3); however, plaque burden at the minimal lumen area was greater in shaft locations (79.3 ± 9.4% vs 72.1 ± 9.2%, p = 0.01). The frequency of positive remodeling in shaft versus aorto-ostial lesions was 70.2% versus 26.7% (p = 0.002). SVG shaft lesions have more soft plaque and larger plaque burdens and undergo positive remodeling more frequently than SVG aorto-ostial lesions. These IVUS differences may account for some of the location-specific differences in interventional complications.
