Predictors of Vessel Remodeling Following Directional Coronary Atherectomy

The purpose of this study was to clarify predictors of vessel remodeling following directional coronary atherectomy (DCA). Negative remodeling after DCA leads to restenosis. However, little is known about the predictors of the vessel remodeling. Serial IVUS was performed in 43 lesions. The vessel remodeling was defined as adaptive if vessel area at follow-up minus postprocedure vessel area was > 0 mm², or as constrictive if < 0 mm². Adaptive remodeling occurred in 21 (49%) lesions. Postprocedure percent plaque area was smaller in the adaptive group (32.9% ± 5.7% vs. 45.5% ± 8.8%; P < 0.005). At follow-up, vessel area was larger in the adaptive group. However, plaque area was similar between the two groups. As a result, lumen area was larger in the adaptive group. Multivariate analyses showed that postprocedure percent plaque area < 40% was the only predictor of adaptive remodeling (odds ratio, 6.68; P < 0.05).