Intravascular ultrasound assessment of iliac stent procedures

Purpose: To determine whether intravascular ultrasound (IVUS) is more sensi tive in identifying incomplete stent deployment or mechanical disruption co mpared to angiography. Methods: Over a 9-month period, 44 patients (25 men; mean age 63 years, ran ge 36-88) treated for common or external iliac artery stenoses with balloon angioplasty and stenting underwent IVUS interrogation following completion arteriography. Results: One hundred nine stents were deployed in the 44 patients. Of these , 29 (27%) stents (in 45% of patients) were found by IVUS to be incompletel y deployed or to have an associated mechanical disruption despite a normal completion arteriogram. Further treatment (repeat dilation or additional st enting) was performed in 28 cases; 1 hemodynamically insignificant dissecti on was not treated. Twenty-six (93%) of these interventions were successful as determined by IVUS; 2 underexpanded stents did nor respond to redilatio n. Conclusions: Incomplete stent deployment or mechanical problems associated with stenting were common in this study, occurring in nearly half of the pa tients. IVUS has clinical utility in identifying incomplete deployment or m echanical problems in stents with an increased sensitivity compared to cont rast angiography.