Angiographic morphology of restenosis after percutaneous transluminal coronary angioplasty

Abstract

Restenosis after successful percutaneous transluminal coronary angioplasty (PTCA) occurs frequently. To better define the restenosis process, a quantitative analysis was performed of coronary angiographic morphologic characteristics at restenosis, before and immediately after PTCA. In 22 patients cine frames showing stenosis at its most severe narrowing were traced and quantitatively analyzed. Immediately after PTCA, stenosis diameter (0.7 +/- 0.3 to 1.9 +/- 0.6 mm, mean +/- standard deviation, p less than 0.05) was increased; percent stenosis (77 +/- 11 to 34 +/- 16%, p less than 0.05), neck index (1.2 +/- 1.4 to 0.5 +/- 0.6, p less than 0.05) and irregularity (9 of 22 patients) were decreased. At follow-up, quantitative coronary morphologic values in most cases were similar to those before PTCA. There were individual changes, which occurred in an unpredictable and highly variable fashion, so that average values were not changed. The eccentricity ratio was not significantly changed by angioplasty or at restenosis. Thus, although successful PTCA results in specific changes in angiographic coronary stenotic morphology, these are reversed by the restenosis process.