RESTENOSIS OF PERIPHERAL STENTS AND STENT GRAFTS AS REVEALED BY INTRAVASCULAR SONOGRAPHY - IN-VIVO COMPARISON WITH ANGIOGRAPHY

OBJECTIVE. Our objective was to compare intravascular sonography with digital subtraction angiography (DSA) in the assessment of luminal dim ension and morphologic features of endovascular stents and stent graft s. MATERIALS AND METHODS. Thirty-seven pelvic and 24 femoral stents (1 2 Wallstents: 27 covered and 22 uncovered nitinol stents) in 50 patien ts were evaluated 15 +/- 10 months after implantation by DSA and intra vascular sonography, The degree of maximum in-stent restenosis as reve aled by DSA and intravascular sonography was compared for each locatio n, Morphologic features of the stents and stenoses were also assessed. RESULTS, Intravascular sonography and DSA correlated well (R-2 = .96) in determining in-stent restenosis, In-stent restenosis was underesti mated by 13% +/- 6% by DSA compared with intravascular sonography. Dif ferences in determining in-stent restenosis with intravascular sonogra phy and DSA were not associated with severity of stenosis or type of s tent, Intravascular sonography revealed incomplete expansion of stents in 21 cases, whereas DSA revealed incomplete expansion of stents in s even cases. The intra-and interobserver variabilities in our study wer e 4% and 5%, respectively. CONCLUSION. In-stent restenoses are underes timated with DSA, Intravascular sonography is superior to DSA for dete ction of incomplete stent expansion.