Effect of preinterventional arterial remodeling on intimal hyperplasia after implantation of a polymer-based paclitaxel-eluting stent: Angiographic and IVUS study

Background The aim of this study was to evaluate the effect of preinterventional arterial remodeling on in-stent intimal hyperplasia (IH) after the implantation of a polymer-based paclitaxel-eluting stent. Methods The study population consisted of 55 patients (61 lesions) with a de novo lesion treated with a paclitaxel-eluting stent. The lesions were divided into two groups, positive or intermediate (PR/IR), and negative remodeling (NR) groups, according to the preinterventional arterial remodeling. Angiographic and IVUS examinations were performed preintervention, postintervention and at 9 months of follow-up. Results The remodeling index (RI) was 1.19 ± 0.16 in the PR/IR group and 0.81 ± 0.10 in the NR group. At follow-up, the late loss was significantly larger in the PR/IR group than in the IR group. (0.65 ± 0.58 mm vs. 0.29 ± 0.5 mm, p = 0.017). The external elastic membrane cross-sectional area (CSA) (18.68 ± 5.39 vs. 12.87 ± 3.72 mm2, p = 0.000), plaque CSA (16.99 ± 4.04 vs. 10.34 ± 3.45 Mm2, p = 0.000) and plaque index (85.84 ± 5.02 vs. 81.80 ± 7.26%, p = 0.048) during the preintervention period and IH volume during the follow-up were significantly larger in the PR/IR group than in the NR group (17.98 ± 16.7 mm3 vs. 4.59 ± 12.4 mm3; p < 0.001). Further, the percentage of the change in the IH was also larger in the PR/IR group than in the NR group (13.49 ± 11.78% vs. 4.12 ± 10.76%; p = 0.002). A significant positive correlation was found between the preinterventional RI and follow-up IH CSA (r = 0.406, p = 0.001). Conclusions The preinterventional arterial remodeling influenced the development of the IH after the implantation of the polymer-based paclitaxel-eluting stent which had a greater effect on reducing the IH accumulation in the lesions with preinterventional negative remodeling characteristics.