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Related Experiment Videos

A novel quantitative method for evaluating diffuse in-stent narrowing at follow-up angiography.

Y Ishii1, A W van Weert, E Hekking

  • 1Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|December 18, 2001
PubMed
Summary

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Predictors of coronary in-stent restenosis: importance of angiotensin-converting enzyme gene polymorphism and treatment with angiotensin-converting enzyme inhibitors.

Journal of the American College of Cardiology·2001

A new diffuse index (DI) objectively quantifies in-stent restenosis. This parameter, correlated with plaque area, predicts major adverse cardiac events, aiding clinical decisions.

Area of Science:

  • Cardiovascular research
  • Medical imaging analysis
  • Interventional cardiology

Background:

  • In-stent restenosis (ISR) presents challenges in objective characterization.
  • Distinguishing diffuse from focal ISR is crucial for treatment planning.

Purpose of the Study:

  • To introduce and validate a new quantitative parameter, the diffuse index (DI).
  • To assess the correlation of DI with percentage plaque area (% PA).
  • To evaluate the predictive value of DI and % PA for major adverse cardiac events (MACE).

Main Methods:

  • Quantitative coronary angiography (QCA-CMS) was used to analyze 346 lesions in 343 patients.
  • The diffuse index (DI) was calculated as the ratio of lesion length at a specific reference diameter function (RDF) to total stent length (DI = [LL(x)/SL]).

Related Experiment Videos

  • Correlation between DI and % PA was assessed, and the incidence of MACE was analyzed based on DI and % PA thresholds.

    • Main Results:

    • An excellent correlation (r > 0.88) was observed between DI at 88% RDF and % PA across different stent types.
    • The correlation curves were consistent regardless of the stent used.
    • A combination of DI > 0.8 and % PA > 30% was associated with a high incidence of MACE (52%).

    Conclusions:

    • The diffuse index (DI) is a novel, objective quantitative parameter for characterizing ISR as diffuse or focal.
    • DI shows a strong correlation with % PA, offering a consistent measure across various stents.
    • DI combined with % PA can identify patients at high risk for MACE.