Intravascular ultrasound evaluation of peripheral arterial stent-grafts

RATIONALE AND OBJECTIVES. TO evaluate neointimal hyperplasia, plaque distri bution, and morphologic features of peripheral arterial stent-grafts with i ntravascular ultrasound (IVUS). METHODS. Twenty-three patients with stenoses or occlusions of the pelvic or femoral arteries were treated with 31 stent-grafts. Angiography and IVUS o f the stented artery were performed 13.9 +/- 9.7 months after stent implant ation, Maximum in-stent restenosis was measured by IVUS, Plaque composition and lesion topography were also assessed. RESULTS. The maximum in-stent restenosis was 53.2 +/- 26.5% for the femoral and 14.2 +/- 10.1 for pelvic arterial stent-grafts. Predilection sites of maximum neointimal tissue accumulation were the edges of the femoral stent- grafts. Only small amounts of neointimal hyperplasia were found in the sten t-graft edges. No predilection site for maximum in-stent restenosis was fou nd for the pelvic arterial stent-grafts. CONCLUSIONS. Predilection sites of maximum in-stent restenosis were the edg es of femoral stent-grafts in contrast to pelvic stent-grafts, Femoral sten t-grafts showed significantly higher graded stenoses with IVUS than iliac s tent-grafts, The authors' findings at IVUS did not change the treatment pla n in these patients treated with stent-grafts.