Intravascular ultrasound-guided renal artery stenting

Citation
G. Dangas et al., Intravascular ultrasound-guided renal artery stenting, J ENDOVAS T, 8(3), 2001, pp. 238-247
Citations number
27
Categorie Soggetti
Cardiovascular & Respiratory Systems
Journal title
JOURNAL OF ENDOVASCULAR THERAPY
ISSN journal
15266028 → ACNP
Volume
8
Issue
3
Year of publication
2001
Pages
238 - 247
Database
ISI
SICI code
1526-6028(200106)8:3<238:IURAS>2.0.ZU;2-D
Abstract
Purpose: To evaluate the clinical outcomes of patients undergoing renal art ery stenting with intravascular ultrasound (IVUS) guidance and compare meas urements between IVUS and angiography. Methods: One hundred thirty-one patients (71 women; mean age 71 +/-8 years) underwent IVUS-guided Palmaz stent implantation in 153 stenotic renal arte ries at a single center. The indications for stenting were uncontrolled hyp ertension (102, 77.9%), renal insufficiency (10, 7.6%), and both conditions (19, 14.5%). The majority of lesions were ostial (114, 74.5%); the remaind er occupied the proximal renal artery (39, 25.5%). The mean lesion length a nd diameter stenosis were 6.5 +/-3.0 mm and 74%+/- 10%, respectively, as me asured by angiography. Data were recorded in a prespecified database; angio graphic and IVUS images were analyzed at dedicated core laboratories and co mpared. Results: Angiographic success was achieved in all patients, but IVUS indica ted the need for additional intervention in 36 (23.5%) cases. There was str ong correlation between the angiographic and IVUS measurements of lesion le ngth (r = 0.60, p < 0.0001) and pre-/postprocedural minimal luminal diamete r (r = 0.72 and 0.63, respectively; p < 0.0001). The mean contrast volume w as 74 +/- 18 mL per case. In-hospital renal failure occurred in 8 (6.1%) pa tients; 2 (1.5%) required transient hemodialysis. At a mean 15-month follow -up, patients were treated with fewer anti hypertensive medications (p = 0. 05), and systolic and diastolic arterial blood pressures had decreased (p = 0.001); no significant change was noted in serum creatinine. Conclusions: IVUS-guided stenting facilitates safe renal artery revasculari zation. IVUS imaging may complement angiography in certain cases, which sho uld be studied further in prospective studies with iodinated or noniodinate d contrast agents.