{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T18:46:51Z","timestamp":1791312411643,"version":"4.3.1"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,8,28]],"date-time":"2019-08-28T00:00:00Z","timestamp":1566950400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006022","name":"Saha Cardiovascular Research Center, University of Kentucky","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006022","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the incidence, predictors, and outcomes of distal vessel expansion on intravascular ultrasound (IVUS) after recanalization of chronic total occlusion (CTO) particularly using new\u2010generation drug\u2010eluting stent (DES).<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>The luminal changes of narrowed vessels distal to CTO segments after recanalization using new\u2010generation DES have rarely been studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This substudy of the CTO\u2010IVUS (Chronic Total Occlusion InterVention with drUg\u2010eluting Stents) trial included a total of 69 new\u2010generation DES\u2010treated CTOs with serial matched IVUS analyses at index percutaneous coronary intervention (PCI) and at 1\u2010year follow\u2010up. The predictors of distal vessel expansion, any increase of lumen area at the distal reference (LA<jats:sub>distal<\/jats:sub>) on 1\u2010year follow\u2010up IVUS, were evaluated by multivariable binary logistic analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Distal vessel expansion was identified in 46 (67%). Independent determinants of distal vessel expansion were proximal CTO, a smaller LA<jats:sub>distal<\/jats:sub> at the index PCI, a greater minimal stent area\u2010to\u2010LA<jats:sub>distal<\/jats:sub> (MSA\u2010to\u2010LA<jats:sub>distal<\/jats:sub>) ratio, and a greater lumen area at the distal stent edge\u2010to\u2010LA<jats:sub>distal<\/jats:sub> (LA<jats:sub>edge<\/jats:sub>\u2010to\u2010LA<jats:sub>distal<\/jats:sub>) ratio. The cut\u2010off values of a MSA\u2010to\u2010LA<jats:sub>distal<\/jats:sub> ratio and a LA<jats:sub>edge<\/jats:sub>\u2010to\u2010LA<jats:sub>distal<\/jats:sub> ratio predicting the distal vessel expansion by receiver operating characteristic curve analysis were 1.0 and 1.1, respectively. During the median 5.1\u2009years, rates of target vessel revascularization, cardiac death, and stent thrombosis were similar in the distal vessel\u2010expanded and nonexpanded groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>After opening CTO with new\u2010generation DES, two\u2010thirds of patients exhibited distal vessel expansion on 1\u2010year follow\u2010up IVUS. Expansion determinants were a proximal CTO, lower LA<jats:sub>distal<\/jats:sub>, and larger stent areas relative to the LA<jats:sub>distal<\/jats:sub> (modifiable procedural predictors).<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.28461","type":"journal-article","created":{"date-parts":[[2019,8,28]],"date-time":"2019-08-28T10:00:32Z","timestamp":1566986432000},"page":"154-164","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Incidence, predictors, and outcomes of distal vessel expansion on follow\u2010up intravascular ultrasound after recanalization of chronic total occlusions using new\u2010generation drug\u2010eluting stents: Data from the CTO\u2010IVUS randomized trial"],"prefix":"10.1002","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4893-039X","authenticated-orcid":false,"given":"Sung\u2010Jin","family":"Hong","sequence":"first","affiliation":[{"name":"Division of Cardiology Severance 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