Evaluation of renal arteries with use of gadoterate meglumine-, CO2-, and iodixanol-enhanced DSA measurements versus histomorphometry in renal arteryrestenosis in rabbits

PURPOSE: To experimentally evaluate gadolinium (Gd)-, carbon dioxide (CO2)- , and iodixanol-enhanced digital subtraction angiography (DSA) versus histo morphometry in the assessment of renal artery stenosis. MATERIALS AND METHODS: Fifteen male New Zealand White rabbits weighing 4.0 kg underwent percutaneous catheterization. Renal artery stenosis was induce d by bilateral overdilation-deendothelialization (balloon diameter = 2 mm). The percentage of artery overdilation was 33%. After 4 weeks, the rabbits were randomized into two groups: group A underwent right-sided therapeutic percutaneous transluminal renal angioplasty (PTRA) (balloon diameter = 1.5 mm). After another 4 weeks, the renal arteries were evaluated by gadoterate -, iodixanol-, and CO2-enhanced selective quantitative DSA. The rabbits wer e then killed and renal arteries were perfusion-fixed for 60 minutes. Seria l orcein-stained 4-um-thick slices were prepared for histomorphometry. RESULTS: Based on morphometric data of single-stenosis versus post-PTRA res tenosis lesions, no significant difference was observed between Gd- and iod ixanol-enhanced quantitative DSA (r(2) > 0.95), although the iodine/Gd dens ity ratio was equal to 3.5. Carbon dioxide less reliably allowed quantitati ve DSA (r(2) < 0.75). CONCLUSION: Gd-based contrast agents represent a highly reliable alternativ e in experimental quantitative DSA evaluation of renal artery restenosis.