Effects of Antiplatelet Agents and Other Factors on Neointimal Proliferation in Iliac Artery Stenting: Intravascular Ultrasound Analysis

Objective: To use intravascular ultrasound to investigate the effects of antiplatelet agents and other factors on neointimal proliferation after stent implantation for iliac artery stenosis. Patients and methods: The subjects were 109 patients with peripheral arterial disease who underwent stent implantation in the iliac artery. Intravascular ultrasound was performed to evaluate lesion area, stent dilatation and neointimal proliferation before, just after, and six months after stenting. Multiple regression analysis was performed to examine the relationship of the neointimal proliferation rate with antiplatelet agents and other factors. Results: At the time of stent implantation, a Palmaz stent resulted in a significant increase in lumen area compared with a Wallstent (p < 0.05). Six months later, self-expanding Wallstent and Luminexx stents showed a significant increase in the stent-lumen area (p < 0.05). The neointimal proliferation rate showed a significant negative correlation with beraprost and cilostazol (p < 0.05) and a significant positive correlation with serum creatinine (p < 0.01). There was no significant difference in the vessel lumen area including the proliferated intima among the three stents. Conclusion: Suppression of neointimal proliferation can be achieved with beraprost or cilostazol whereas renal dysfunction may increase neointimal proliferation following stent implantation in iliac artery lesions.