701-3 Prediction of the Risk of Angiographic Restenosis by Intracoronary Ultrasound Imaging After Coronary Balloon Angioplasty

Abstract

The aim of the PICTURE study is to relate arterial wall morphology on intracoronary ultrasound images (ICUS) after balloon angioplasty (BA) to the risk of quantitative coronary angiographic (QCA) restenosis at 6 months. Of the 200 patients included, data are now complete in 133. With 112 (84%) repeat angiograms and 8 patients with 2 lesions, 119 lesions were available for interim analysis. A > 50% diameter stenosis on QCA at 6 months was present in 30.3%. On QCA after BA, mean minimal lumen diameter was 1.71 in the lesions that developed restenosis, versus 1.88 in the group that did not (p = 0.02). Similarly, diameter stenosis after BA was 43.4% versus 35.3%, respectively (p < 0.0001), confirming previous studies. As determined by 3 to 5 independent ICUS observers in each case, 86% of lesions were ruptured (radial tear), with a restenosis rate of 32%, versus 18% in the non-ruptured lesions (p = 0.35). Dissection (circumferential tear) was diagnosed in 64%, with a restenosis rate of 32%, versus 28% in the nondissected lesions (p = 0.65). Plaque type (soft (40%, restenosis 24%), hard (10%, restenosis 27%) or calcific (50%, restenosis 33%), and eccentricity (65%, restenosis 29%) did not predict the risk of restenosis. Two observers independently measured lumen area, plaque area (media area minus lumen area) and percent obstruction (plaque area/media area) on ICUS, and the two values were averaged for analysis. There were no significant differences in these parameters between groups with and without subsequent restenosis (p = 0.53, 0.44 and 0.16, respectively). Qualitative and quantitative parameters on ICUS after successful balloon angioplasty do not seem to predict the risk of angiographic restenosis at 6 months.