Effect of balloon angioplasty in femoropopliteal arteries assessed by intravascular ultrasound.

Abstract

To study the effects of balloon angioplasty (PTA) of the femoropopliteal artery with intravascular ultrasound (IVUS). Corresponding IVUS cross-sections (n = 1033) obtained before and after PTA from 115 procedures were analysed. Vascular damage including plaque rupture, dissection and media rupture was assessed. Free lumen area (FLA), media-bounded area (MBA) and plaque area (PLA) were measured. After PTA vascular damage was seen at the target site in 83 (72%) arteries: plaque rupture in 30 (26%), dissection in 66 (57%) and media rupture in 20 (17%) arteries. The FLA increased from 5.4 +/- 3.4 mm2 to 14.1 +/- 5.0 mm2 (p < 0.001), MBA increased from 26.9 +/- 10.0 mm2 to 32.9 +/- 10.7 mm2 (p < 0.001) and PLA decreased from 21.6 +/- 8.5 mm2 to 18.8 +/- 8.0 mm2 (p < 0.001). The increase in MBA accounted for 68% of lumen gain. The frequency of vascular damage and the relative contribution of MBA increase and PLA decrease to luminal gain were not different in procedures with balloon diameter < or = 5 mm and > or = 6 mm. Vascular damage is common following PTA. Lumen gain is mainly due to vessel expansion and, to a lesser extent, to a decrease in plaque area.