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Background and objectives Intermediate coronary lesion that can be under- or over-estimated by visual estimation frequently results in stenting of functionally nonsignificant lesions or deferral of percutaneous coronary intervention (PCI) of significant lesions inappropriately. We evaluated current status of PCI for intermediate lesions from a standardized database in Korea. Methods We analyzed the Korean percutaneous coronary intervention (K-PCI) registry data which collected a standardized PCI database of the participating hospitals throughout the country from January 1, 2014, through December 31, 2014. Intermediate lesion was defined as a luminal narrowing between 50% and 70% by visual estimation and then compared whether the invasive physiologic or imaging study was performed or not. Results Physiology-guided PCI for intermediate lesions was performed in 16.8% for left anterior descending artery (LAD), 9.8% for left circumflex artery (LCX), 13.2% for right coronary artery (RCA). PCI was more frequently performed using intravascular ultrasound (IVUS) than using fractional flow reserve (FFR) for coronary artery segments (27.7% vs. 13.9% for LAD, 32.9% vs. 8.1% for LCX, and 33.8% vs. 10.8% for RCA). In accordance with or without FFR, PCI for intermediate lesions was more frequently performed in the hospitals with available FFR device than without FFR, especially in left main artery (LM), proximal LAD lesion (40.9% vs. 5.9% for LM, 24.6% vs 7.6% for proximal LAD). Conclusions These data provide the current PCI practice pattern with the use of FFR and IVUS in intermediate lesion. More common use of FFR for intermediate lesion should be encouraged.

Identifying patients with high bleeding risk (HBR) is important when making decisions for antiplatelet therapy strategy. This study evaluated the impact of ticagrelor monotherapy after 3-month dual antiplatelet therapy (DAPT) according to HBR in acute coronary syndrome (ACS) patients treated with drug eluting stents (DESs).In this post-hoc analysis of the TICO trial, HBR was defined by 2 approaches: meeting Academic Research Consortium for HBR (ARC-HBR) criteria or Predicting Bleeding Complications in Patients Undergoing Stent Implantation and Subsequent DAPT (PRECISE-DAPT) score ≥25. The primary outcome was a 3-12 months net adverse clinical event (composite of major bleeding and adverse cardiac and cerebrovascular events).Of the 2,980 patients without adverse events during the first 3 months after DES implantation, 453 (15.2%) were HBR by ARC-HBR criteria and 504 (16.9%) were HBR by PRECISE-DAPT score. The primary outcome rate was higher in HBR versus non-HBR patients (by ARC-HBR criteria: hazard ratio [HR], 2.87; 95% confidence interval [CI], 1.76-4.69; p0.001; by PRECISE-DAPT score: HR, 3.09; 95% CI, 1.92-4.98; p0.001). Ticagrelor monotherapy after 3-month DAPT was associated with lower primary outcome rate than ticagrelor-based 12-month DAPT regardless of HBR by ARC-HBR criteria, with similar magnitudes of therapy effect for HBR and non-HBR patients (p-interaction=0.400). Results were consistent by PRECISE-DAPT score (p-interaction=0.178).In ACS patients treated with DESs, ticagrelor monotherapy after 3-month DAPT was associated with lower rate of adverse clinical outcomes regardless of HBR, with similar magnitudes of therapy effect between HBR and non-HBR.ClinicalTrials.gov Identifier: NCT02494895.

Background and objectives Prognostic value of additional carotid Doppler evaluations to carotid intima-media thickness (IMT) and plaque has not been completely evaluated. Subjects and methods A total of 1119 patients with risk factors for, but without, overt coronary artery disease (CAD), who underwent both carotid ultrasound and Doppler examination were included in the present study. Parameters of interest included peak systolic and end-diastolic velocities, resistive indices of the carotid arteries, IMT, and plaque measurements. The primary end-point was all-cause cerebro-cardiovascular events (CVEs) including acute myocardial infarction, coronary revascularization therapy, heart failure admission, stroke, and cardiovascular death. Model 1 covariates comprised age and sex; Model 2 also included hypertension, diabetes and smoking; Model 3 also had use of aspirin and statin; and Model 4 also included IMT and plaque. Results The mean follow-up duration was 1386±461 days and the mean age of the study population was 60±12 years. Amongst 1119 participants, 43% were women, 57% had a history of hypertension, and 23% had diabetes. During follow-up, 6.6% of patients experienced CVEs. Among carotid Doppler parameters, average common carotid artery end-diastolic velocity was the independent predictor for future CVEs after adjustments for all models variables (HR 0.95 per cm/s, 95% confident interval 0.91-0.99, p=0.034 in Model 4) and significantly increased the predictive value of Model 4 (global χ(2)=59.0 vs. 62.8, p=0.029). Conclusion Carotid Doppler measurements in addition to IMT and plaque evaluation are independently associated with future CVEs in asymptomatic patients at risk for CAD.

Background and objectives Recently, Genoss drug-eluting stent (DES)™ stent comprising cobalt-chromium platform with an ultrathin strut thickness, sirolimus, and an abluminal biodegradable polymer was developed. Owing to the lack of substantial evidence for the safety and efficacy of this stent, we report 12-month results of the Genoss DES™ stent. Methods We analyzed subjects who were eligible for a 12-month follow-up from the ongoing Genoss DES™ registry, which is a prospective, single-arm, observational, multicenter trial to investigate the clinical outcomes after the successful Genoss DES™ stent implantation among all-comers. The primary endpoint was a device-oriented composite outcome, defined as cardiac death, target vessel-related myocardial infarction, and target lesion revascularization at 12-month follow-up. Results Among 622 subjects, the mean age of subjects was 66.5±10.4 years, 70.6% were males, 67.5% had hypertension, and 38.3% had diabetes. The implanted stent number, diameter, and length per patient were 1.5±0.8, 3.1±0.4 mm, and 36.0±23.3 mm, respectively. At 12-month clinical follow-up, the primary endpoint occurred only in 4 (0.6%) subjects. Conclusions The novel Genoss DES™ stent exhibited excellent safety and efficacy in real-world practice.

Background and Objectives: We investigated the effect of the additional use of abciximab during percutaneous coronary intervention (PCI) on the level of procoagulant microparticles (MPs) in patients with ST-segment elevation myocardial infarction (STEMI) who had undergone primary PCI. Subjects and Methods: In this study, we studied 86 patients with STEMI (72 men, age 58±13) who had undergone primary PCI. The decision to administer abciximab immediately prior to PCI was left to the discretion of the operator. Blood samples for analysis of MPs were obtained from the femoral artery before and after PCI. MPs with procoagulant potential were measured using a commercial kit. The cellular origins of MPs were determined by antigenic capture with specific antibodies. Results: Procoagulant MPs captured onto annexin V were not changed significantly after PCI {13.4±13.2 nM vs. 13.2±16.1 nM phosphatidylserine equivalent (PS eq), p=0.479}. Abciximab was used in 30 of 86 patients (35%) immediately prior to PCI. In patients who had undergone PCI without abciximab, no significant change in the level of MPs was observed after PCI. However, in the abciximab group, the level of circulating MPs was significantly decreased after PCI (12.0 ±10.7 nM vs. 7.8±11.7 nM PS eq, p=0.018). Levels of endothelial- and platelet-derived MPs also showed a significant reduction after PCI in the abciximab group. Conclusion: Primary PCI with additional abciximab significantly reduced the level of procoagulant MPs regardless of their cellular origins in patients with STEMI. (Korean Circ J 2013;43:600-606)

Hyperkalemia is a common adverse effect of treatment for heart failure and is associated with high mortality and morbidity. The cardiac manifestations of hyperkalemia include various electrocardiogram changes. We describe a case of a 74-year-old woman with heart failure and permanent atrial fibrillation who reverted to normal sinus rhythm during recovery from hyperkalemia.

Background—Biological mechanisms underlying statin and angiotensin II type 1 receptor blocker therapies differ. Therefore, we compared vascular and metabolic responses to these therapies either alone or in combination in hypercholesterolemic, hypertensive patients. Methods and Results—This was a randomized, double-blind, placebo-controlled crossover trial with 3 treatment arms (each 2 months) and 2 washout periods (each 2 months). Forty-seven hypertensive, hypercholesterolemic patients were given simvastatin 20 mg and placebo, simvastatin 20 mg and losartan 100 mg, or losartan 100 mg and placebo daily during each 2-month treatment period. Losartan alone or combined therapy significantly reduced blood pressure compared with simvastatin alone. Compared with losartan alone, simvastatin alone or combined therapy significantly changed lipoproteins. All 3 treatment arms significantly improved flow-mediated dilator response to hyperemia and decreased plasma malondialdehyde and monocyte chemoattractant protein-1 levels relative to baseline measurements. However, these parameters were changed to a greater extent with combined therapy compared with simvastatin or losartan alone (both P0.001 and P0.030 for monocyte chemoattractant protein-1 by ANOVA). Combined therapy or losartan alone significantly increased plasma adiponectin levels and insulin sensitivity (determined by QUICKI) relative to baseline measurements. These changes were significantly greater than in the group treated with simvastatin alone (P0.001 for adiponectin, P0.029 for QUICKI by ANOVA). Conclusions—Simvastatin combined with losartan improves endothelial function and reduces inflammatory markers to a greater extent than monotherapy with either drug in hypercholesterolemic, hypertensive patients. (Circulation. 2004; 110:3687-3692.)

Background and Objectives:Sirolimus-eluting stent (SES) is very effective for preventing in-stent restenosis through the suppression of neointimal proliferation. Treatment failure cases related to stent fracture have recently been reported on, but any studies concerning the pattern or mechanism of SES fracture are very rare. Subjects and Methods:Between December 2003 to January 2005, 457 patients underwent follow-up coronary angiography after SES implantation at three referral center. We reviewed the angiographic and procedural data for eleven of theses patients [6 males (55%), mean age: 60 year-old age, range: 43-74 years] who were proven to have experience complete SES fracture. Results:The left anterior descending artery (LAD) and right coronary artery (RCA) stent fracture were 7 cases (63%) and 4 cases (37%), respectively. Myocardial bridge was shown in 6 cases with LAD fracture (86%). Overlapping stent implantation was performed in 5 cases (45%). The mean value of the maximal angulations at the fracture site before intervention was 50° (range; 39-70°) and the mean change between the maximal and minimal angulations was 13.2° (range; 2-28°). The mean stent diameter and length were 3.0 mm (range; 2.75-3.50 mm) and 40 mm (range; 23-52 mm). Stent inflation with high pressure was performed on 6 cases (54%) and it’s frequency was higher in the RCA than the LAD (3 cases, 75%, mean inflation pressure: 13.1 mmHg). The mean follow-up duration was 7.2 month and only 2 cases were admitted due to the recurrent chest pain. The binary restenosis rate was 55% (6 cases) and the restenotic lesions were treated by balloon angioplasty in 2 cases and additional stenting was done in 2 cases. Conclusion:Our results demonstrated that SES fracture occurred in 7 cases with LAD lesion and in 4 cases with RCA lesion. Long stenting including overlapping implantation and more than 40° angulated long stent implantation may be the factors for SES fracture. Our results also showed high pressure stent inflation was performed more frequently at the RCA lesion, and myocardial bridge and kinking motion was detected more frequently at the LAD lesions. (Korean Circulation J 2006;36:443-449)

Background and Objectives：Time-phasic development of nitrate tolerance in cardiovascular diseases is very important because it can contribute to the advent of blunted vasodilation or rebound ischemia even during continuous NTG treatment. In such a condition, we should change the therapeutic regimen of nitrate treatment to prevent the worsening of symptoms. Materials and Methods：We created a nitrate-tolerant rat model using an osmotic minipump, and we examined the hemodynamic response to bolus NTG infusion in vivo. We checked the phosphodiesterase (PDE)1A1 mRNA and protein level by relative quantitative RT-PCR and western blot analysis. We used 8-cpt-cGMP for investigating the development of a time-phasic nitrate tolerance mechanism after nitrate infusion. Results：NTG-treated rats revealed a significant decrease in NTG-induced MAP drop (nitrate tolerance) from 1-day and this continued to the third day. The mRNA and protein levels of PDE1A1 similarly increased during these periods. Conclusion：This study revealed the development of time-phasic nitrate tolerance from the the aspects of in vivo hemodynamic responses and PDE 1A1 gene expression, and our work supports the need for further investigation to come up with a different therapeutic strategy and new drugs. (Korean Circulation J 2005;35:94-99)

A case of antiphospholipid antibody syndrome, accompanied by valvular heart disease and Moya moya syndrome, has never been reported. Here, we report on a case that had mitral regurgitation and Moya moya syndrome, associated with antiphospholipid antibody syndrome secondary to systemic lupus erythematosus. This patient underwent a mitral valve replacement for mitral valve regurgitation. The postoperative course was uneventful, and the pathological findings of the mitral valve showed a degenerative change, due to chronic inflammation, a proliferative fibrous change and calcification, but without thrombus formation. However, the patient returned to the hospital with a cerebral hemorrhage, which was caused by Moya moya syndrome. Surgical drainage was performed, and the patient was discharged without any complications. The patient is on anticoagulation and immunosuppression drugs, with no problems to date. (Korean Circulation J 2003;33 (7):620-624)

Background and Objectives:Angiotensin II (Ang II)opposes the actions of nitric oxide (NO). A balance between Ang II and NO is critical for the maintenance of normal vessel tone, and is dependent on the intracellular cGMP level. We examined the effect of Ang II treatment on cGMP-hydrolyzing phosphodiesterases (PDEs), such as PDE1 and PDE5, the two major cGMP-hydrolyzing PDEs present in rat aortic vascular smooth muscle cells (VSMCs). We also investigated whether the Ang II signaling pathway affects the expression of the cGMP-hydrolyzing PDEs gene. Materials and Methods:VSMCs from SpragueDawley rats were incubated. Relative quantitative RT-PCR was performed for quantitation of PDE1A1, PDE5A1 mRNA expression a following in vitro Ang II treatment, and also done after pretreatment with inhibitors of the Ang II type1 (AT1) receptor, protein kinase C (PKC), mitogen activated protein kinase kinase (MEK) 1/2 and janus kinase 2 (JAK2) to investigate the effect of the Ang II signaling pathway on PDE1A1, PDE5A1 gene expression. Western blot analyses were performed to evaluate the changes of PDE1A1 and PDE5A1 protein level following treatment with Ang II. Results:Ang II (400 nM) increased the PDE1A1 and the PDE5A1 mRNA expression by 2.4 and 2.3-fold, respectively, 1 hour after treatment. Ang II also increased the protein level 2 hours after treatment. Inductions of PDE1A1 and PDE5A1 mRNA were blocked by the AT1 receptor inhibitors, PKC, MEK 1/2 and JAK2. Conclusion:In vitro Ang II treatment upregulates the PDE1A1, PDE5A1 gene expressions and the protein levels. The PKC, MEK1/2 and JAK2 signaling pathways were essential for the Ang II-mediated PDEs gene regulation. These findings may suggest that Ang II antagonizes NO actions through the upregulation of cGMP-hydrolyzing PDEs gene expressions. (Korean Circulation J 2003;33(2):130-138)

Aortic interruption is a very rare disease that can be classified into congenital and acquired aortic interruption. Congenital aortic interruption generally implies an interruption of the aortic arch and no case of congenital abdominal aortic interruption has been reported. Acquired aortic interruption, on the other hand, can be caused by atherosclerosis, thrombosis, saddle embolism, and arteritis such as Takayasu arteritis. We experienced a case of congenital abdominal aortic interruption accompanied by one well-developed collateral flow presented with secondary hypertension in a 28-year-old female patient. ( ( ( (Korean Circulation J 2001;31(12 :1336-1339

Background:There are many reports about the correlation between cardiovascular disorders and estrogen deficiency in postmenopausal women. The purpose of current study is to know that postmenopausal estrogen therapy may affect the lipid metabolism and endogenous fibrinolytic system and exercise tolerance. Method: We investigated the relation of estrogen treatment (srogen 0.625 mg/day to serum lipid levels, angiotensin converting enzyme activity, plasminogen activator inhibitor-1 and parameters of treadmill test in 22 post- menopausal women of normal coronary artery with abnormal exercise test complained with chest pain accompanied by postmenopausal symptoms. Results:Estrogen treatment significantly elevated the serum HDL- cholesterol level (42.8 to 50.1 mg/dl, p

Background:Plaque compression(and/or redistribution) and vessel expansion are important mechanisms of percutaneous coronary balloon angioplasty. We investigated the mechanisms of balloon angioplasty according to plaque characteristics by intravascular ultrasound and assessed the time-sequencing morphometric changes of target vessels after balloon dilation without catheter change using intravascular ultrasound balloon catheter. Methods:We studied balloon angioplasty in 10 patients(eight male, average age of 55.3 years). Quantitative coronary angiography and intravascular ultrasound images were attained at baseline and at timed intervals of 0sec, 60sec and 180sec post-balloon angioplasty. The following categories were attained:reference diameter, minimal lumen diameter, cross sectional area(CSA) of lumen(L), external elastic membrane(EEM), and plaque+media(P+M). We also assessed the plaque morphology of target lesions and classified them into two groups according to intravascular ultrasound imaging: a soft plaque group versus a group characterized by fibrous and/or mildly calcified plaque. Results:The proportion of plaque compression in the total luminal gain was 80% in the soft plaque group and 70% in the other;the absolute amount of plaque compression was 26.9% in soft plaque and 24.0% in the other group. The time sequencing changes of target lesion EEM CSA of both groups were 14.4±2.9mm, 14.3±3.8mm(baseline), 15.1±2.5mm, 15.4±3.7 mm(immediate), 15.0±2.8mm, 14.5±3.9mm(180sec), those of P+M CSA(target lesion) were 10.4±3.3mm, 10.7 ±2.4mm(baseline), 7.6±2.7mm, 8.1±2.4mm(immediate), 7.9±2.9mm, 8.5±3.4mm(180sec). Target lesion lumen CSA were 4.0±1.1mm 2, 3.6±2.0mm(baseline) 7.5 ±1.1mm, 7.3±3.2mm (immediate) 7.1±1.3mm, 6.0±1.7mm(180sec) respectively. Conclusions:Plaque compression(and/or redistribution) is the predominant mechanism of luminal

Background and Objectives:Carotid artery stenting has evolved as a potential alternative to carotid endarterectomy in patients (pts) with significant carotid artery stenosis. We evaluated the feasibility and long-term outcome of carotid artery stenting in selected pts at high surgical risk. Materials and Methods:Between May, 1996 and September 1998 we performed carotid artery stenting at 35 lesions in 25 pts. There were 23 males and 2 females. Mean age was 63.2±6.6 (range 54-77). Eight four percent (21/25) of the pts had significant coronary artery disease. Sixty four percent (16/25) of the pts had significant peripheral artery lesions. Sixty percent (15/25) of the pts had neurologic symptoms or non-disabling stroke. We used Wallstent in 32 lesions and Palmaz stent in 3 lesions. Carotid stenting was undertaken in 33 internal carotid, 1 common carotid and 1 external carotid lesions. Bilateral carotid stenting was undertaken in forty percent (10/25) of the pts. Results: Carotid stenting was successful in all lesions. One patient died due to massive cerebral hemorrhage 3 days after carotid stenting, who had und-erwent stenting as a rescue procedure for failed endarterectomy. One major stroke developed during procedure with partial recovery. For the combined endpoint of strokes and death within 30 days of procedure, the incidence was 8% and 5.7% in terms of pts and procedures, respectively. On follow-up (12±7 months), we found neither neurologic complications nor death. Angiographic and/or duplex sonography which were performed at 5.5 month in all (18) eligible pts with 24 lesions revealed no evidence of stent deformity or restenosis (50% of diameter stenosis). Mean angiographic stenosis was 20% on follow-up angiography. Conclusion:Carotid artery stenting can be performed with high success and low complication rate in pts with significant carotid artery stenosis especially at high surgical risk. Follow-up clinical outcome of average 12 month was good with low restenosis rate. (Korean Circulation J 1998;28(11):1820-1827)

We report a case of 15-year-old man with beneficial effects of short term growth hormone treatment presenting with cardiomyopathy combined with neuromuscular dystrophy. Transthoracic echocardiography revealed that LV chamber was markedly dilated and global LV systolic function was severely reduced. The findings of electromyography were compatible with neuromuscular dystrophy. Under the impression of cardiomyopathy combined with neuromuscular disease, maximal medical treatments such as inotropic agents, diuretics and ACE inhibitor were tried but we could not attain remarkable clinical improvement. Finally, we started growth hormone injection and after treatment for 3 months, we could attain remarkable clinical and hemodynamic improvement without any side effect. (Korean Circulation J 1998;28(8 :1387-1392

Background:Even after efficacious thrombolytic therapy in patients with acute myocardial infarction, angiographic studies demonstrated significant thrombotic remnants in many patients which makes it difficult to identify the morphological characteristics of the pure underlying plaque of the lesion. The purpose of the current study is to assess the morphological characteristics and calcification of the plaque, and the thrombi remnants in the occluded segments of infarct-related artery in acute myocardial infarction by intravascular ultrasound (IVUS. Methods:Coronary angiography and IVUS studies for the infarct-related arteries were performed at about 6 days after the onset of chest pain in 22 patients (male 19 patients with acute myocardial infarction (AMI. Fifteen patients had been treated with thrombolytics, and all patients received an intravenous infusion of heparin and oral aspirin. Results:1 Coronary angiography demonstrated total occlusion in 2 cases, and angiographic % diameter stenosis was 74.5±18.1%. 2 IVUS identified the soft plaque in 10 cases (45.5% and the hard plaque with or without calcification (54.5%. Plaque rupture was observed in 4 cases, and in one case, slight depression of a part of the plaque without definite rupture suggestive of the plaque erosion was noted. Intraluminal echogenic material suggesting thrombi was documented in 8 (36.4%. 3 % Diameter and % luminal cross-sectional area stenosis on IVUS was 49.0± 19.6% and 71.6±15.3%,respectively. The eccentricity index of the plaque was 3.1±1.7. 4 There was no complication during IVUS studies. Conclusions: IVUS studies in AMI were safe and feasible for identification of the morphological characteristics of the plaque like as plaque rupture and calcification, and presence of thrombi remnants, and it would contribute to decision making as regards the therapeutic measures according to the characteristics of the lesion. (Korean Circulation J 1998;28(6 :931-938

Background:The several kinds of coronary stents havve proven successful in theirrole to treat acute or subacute closures after balloon angioplasty as well as to reduce the restenosis rate in de novo lesions. However, investigations continue in order to develop an ideal stent with a strong, highly flexible, radial force, especially useful in cases of tortuous vessels, lesions at bends, and lesions distal to previously deployed stents. The NIR stent is a recently developed balloon-expandable, stainless- steel, slotted tube stent; it is designed for improved flexibility with a higher radial force when compared with the traditional Palmaz-Schatz stent. We report the immediate results of our experience with the NIR stent. The purpose of the present study was to assess the feasibility, safety and efficacy of the deployment of manually crimped NIR stents in patients with complex coronary anatomy as well as the clinical outcomes within the first month. Methods:Between January and July 1997, 143 NIR stents were implanted in the coronary arteries of 124 patients(male 76%, mean age 56±10 years. Sixty-one patients had UAP, 43 had SA, and 20 patients had AMI. Results: 1 Indications of stenting were de novo lesions in 123(95% and restenosis lesion in 6(5%. 2 Frequency of used stent length was 16mm in 65 cases(46%, 32mm in 60 cases(42%, 25 mm in 12 cases(8%, and 9mm in 6 cases(4%. 3 Single stents were implanted in 115(89% lesions, and overlapping stenting with 2nd NIR stents in 14(11% lesions.

Background:Adaptive remodeling of the wall of diseased arterial segments occurs to compensate for the accumulation of atherosclerotic plaque. Histopathologic studies and intraoperative high-frequency epicardial coronary ultrasound imaging as well as intracoronary ultrasound imaging have shown that human coronary arteries enlarge in parallel with the formation of atherosclerotic plaque. Therefore, the lumen area is preserved until the progressive accumulation of plaque exceeds the compensatory mechanisms of the vessel. In 1995, however, Pastercamp et al. reported that arterial wall constriction (shrinkage) or inadequate enlargement may be a different mechanism associated with the development of severe arterial lumen narrowing in addition to plaque proliferation. The aim of this study is to examine what extent of de novo native coronary arterial stenosis is accompanied by compensatory enlargement and to find the predictors of inadequate remodeling with intravascualr ultrasound. Methods:Fifty eight patients were enrolled from February 1997 through October 1997. Patients who had the lesion of more than 50% stenosis of minimal luminal diameter in coronary angiography were indicated. The lesion which was located in the ostium or was very tortuous or angulated was excluded. The lesion which had the history of balloon angioplasty or stent insertion was also excluded. We used 20 MHz endosonic intravascular ultrasound catheter. We measured EEM area (External Elastic Membrane area), lumen area and plaque plus media area and analysed plaque characteristics. Results:1) Fifty-eight consecutive patients (43 men, 15 women;mean age 55.4 years, range 33 to 78)who had not undergone previous catheter intervention were studied with a single intravascular ultrasound system. 2) Among 58 patients, 20 patients (35%) had acute myocardial infarction, 30 patients (52%) unstable angina, 6 patients (10%) stable angina and 2 patients (3%) old myocardial infarction. Lesions were located at the left anterior descending arteries in 29 patients (50%), right coronary arteries in 21 patients (36%) and left circumflex coronary artery in 8 patients (14%). 3) Compensatory enlargement was observed in 19 (32%) of 58 lesions and inadequate compensatory enlargement in 39 (68%). 4) EEM and plaque areas at lesion site of compensatory enlargement group were significantly larger than those of inadequate enlargement group (p

Background：Renal artery stenosis(RAS is a major cause of renovascular hypertension and reduced renal function due to ischemic atrophy of kidney. There are several methods to treat the RAS, including are surgery, percutaneous transluminal renal angioplasty, and medical treatment. The purpose of this study is to evaluate the usefulness, safety, and efficacy of percutaneous transluminal stent deployment in RAS. Method：From January 1995 to July 1996, 17 patients underwent renal stent implantation due to renal artery stenosis(11 male, 6 female. The mean age was 49 years old, one patient had both renal artery stenosis and total lesions were 18. The causes of renal artery stenosis were atherosclerosis in 12, fibromuscular dysplasia in 2, Takayasu’ s disease in 2, and autoimmune disease(Bechet’s in one case. Renal artery stenting was performed via femoral artery in 12 lesions and brachial artery in 6 lesions. Follow up was performed by renogram, renal angiogram, and clinical examination. Result：The degree of renal artery stenosis was 83%(70-95%. The lesion sites were 12 ostial and 6 non-ostial lesions. The used renal stents were Palmaz-biliary stent in 17 lesions and Micro-II stent in one lesions. All stents were implanted successfully and there was no residual stenosis in all patients except one case showed 20% residual stenosis due to huge renal artery size. The transstenotic pressure gradients after renal artery stenting was decreased markedly from 74mmHg to 2mmHg. There was no serious complications such as a death, emergency surgery, or nephrectomy. There were two minor complications which were one case of pyelonephritis and one case of inguinal hematoma. After stenting, blood pressure was decreased partially in 13 patients and completely in 2 cases. Conclusion：Renal artery stenting appears to be safe and feasible and the alternative treatment modality to surgery for renal artery stenosis.