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Heart. Feb 1998; 79(2): 137–142.
PMCID: PMC1728616
Atherosclerotic coronary lesions with inadequate compensatory enlargement have smaller plaque and vessel volumes: observations with three dimensional intravascular ultrasound in vivo
C von Birgelen, G Mintz, E A de Vrey, T Kimura, J Popma, S Airiian, M Leon, M Nobuyoshi, P Serruys, and P J de Feyter
Thoraxcenter, University Hospital Rotterdam-Dijkzigt, Netherlands.
Abstract
Objective—To compare vessel, lumen, and plaque volumes in atherosclerotic coronary lesions with inadequate compensatory enlargement versus lesions with adequate compensatory enlargement.
Design—35 angiographically significant coronary lesions were examined by intravascular ultrasound (IVUS) during motorised transducer pullback. Segments 20 mm in length were analysed using a validated automated three dimensional analysis system. IVUS was used to classify lesions as having inadequate (group I) or adequate (group II) compensatory enlargement.
Results—There was no significant difference in quantitative angiographic measurements and the IVUS minimum lumen cross sectional area between groups I (n = 15) and II (n = 20). In group I, the vessel cross sectional area was 13.3 (3.0) mm2 at the lesion site and 14.4 (3.6) mm2 at the distal reference (p < 0.01), whereas in group II it was 17.5 (5.6) mm2 at the lesion site and 14.0 (6.0) mm2 at the distal reference (p < 0.001). Vessel and plaque cross sectional areas were significantly smaller in group I than in group II (13.3 (3.0) v 17.5 (5.6) mm2, p < 0.01; and 10.9 (2.8) v 15.2 (4.9) mm2, p < 0.005). Similarly, vessel and plaque volume were smaller in group I (291.0 (61.0) v 353.7 (110.0) mm3, and 177.5 (48.4) v 228.0 (92.8) mm3, p < 0.05 for both). Lumen areas and volumes were similar.
Conclusions—In lesions with inadequate compensatory enlargement, both vessel and plaque volume appear to be smaller than in lesions with adequate compensatory enlargement.

Keywords: intravascular ultrasound;  ultrasonics;  remodelling;  coronary artery disease
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Figures and Tables
Figure 1
Figure 1  
Principle of automated three dimensional intravascular ultrasound image analysis. Detection of the contours corresponding to the lumen-tissue and media-adventitia interfaces is first performed on two perpendicular longitudinal sections (A, B), reconstructed (more ...)
Figure 2
Figure 2  
Analysis of a 20 mm long mid-right coronary segment with inadequate compensatory vascular enlargement (group I). The vessel cross sectional area is smallest at the target lesion site. Markers indicate that site on the longitudinal sections (right (more ...)
Figure 3
Figure 3  
Adequate compensatory vascular enlargement, as observed in one of the lesion of group II. The vessel cross sectional area is larger at the target lesion site (upper panel) than at the reference site (left mid panel). The lower panel illustrates and underlines (more ...)
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