Stent placement for treatment of renal artery stenosis guided by intravascular ultrasound

Trude C. Leertouwer, Elma J. Gussenhoven, Hans Van Overhagen, Arie J. Man In 'T Veld, Brigit C. Van Jaarsveld

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

PURPOSE: To study the impact of intravascular ultrasound (IVUS) during renal artery stent placement. MATERIALS AND METHODS: Patients (n = 22) with atherosclerotic renal artery stenosis were studied with IVUS after predilation and after angiographically successful stent deployment (diameter stenosis < 10%). After predilation, IVUS was used to assess whether the balloon size selected angiographically was correct (discrepancy balloon- reference lumen diameter < 20%). After stent placement, IVUS images were assessed for (i) complete stent-vessel wall apposition; (ii) complete stent expansion (discrepancy stent-reference lumen diameter < 20%), and (iii) complete lesion covering by the stent. Modification based on IVUS included selection of a larger balloon, additional dilation, and placement of a second stent. Clinical outcome was based on blood pressure, amount of antihypertensive drugs, and glomerular filtration rate during follow-up of 3 months. RESULTS: Stent placement and ultrasound imaging were completed successfully in 18 patients. After predilation, IVUS warranted the use of a larger balloon in five patients. After stent placement, incomplete stent apposition (n = 1), discrepancy between stent and reference lumen diameter (n = 3), and lesion distal to the stent (n = 2) seen on IVUS were treated with additional dilation in five patients and with a second stent in one patient. A larger balloon was used in three patients. Mean blood pressure and amount of antihypertensive drugs decreased (P < .05). CONCLUSIONS: In a number of patients, IVUS monitoring during renal artery stent placement resulted in additional lumen enlargement not considered necessary at angiography.

Original languageEnglish
Pages (from-to)945-952
Number of pages8
JournalJournal of Vascular and Interventional Radiology
Volume9
Issue number6
DOIs
Publication statusPublished - 1 Jan 1998

Cite this

Leertouwer, Trude C. ; Gussenhoven, Elma J. ; Van Overhagen, Hans ; Man In 'T Veld, Arie J. ; Van Jaarsveld, Brigit C. / Stent placement for treatment of renal artery stenosis guided by intravascular ultrasound. In: Journal of Vascular and Interventional Radiology. 1998 ; Vol. 9, No. 6. pp. 945-952.
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title = "Stent placement for treatment of renal artery stenosis guided by intravascular ultrasound",
abstract = "PURPOSE: To study the impact of intravascular ultrasound (IVUS) during renal artery stent placement. MATERIALS AND METHODS: Patients (n = 22) with atherosclerotic renal artery stenosis were studied with IVUS after predilation and after angiographically successful stent deployment (diameter stenosis < 10{\%}). After predilation, IVUS was used to assess whether the balloon size selected angiographically was correct (discrepancy balloon- reference lumen diameter < 20{\%}). After stent placement, IVUS images were assessed for (i) complete stent-vessel wall apposition; (ii) complete stent expansion (discrepancy stent-reference lumen diameter < 20{\%}), and (iii) complete lesion covering by the stent. Modification based on IVUS included selection of a larger balloon, additional dilation, and placement of a second stent. Clinical outcome was based on blood pressure, amount of antihypertensive drugs, and glomerular filtration rate during follow-up of 3 months. RESULTS: Stent placement and ultrasound imaging were completed successfully in 18 patients. After predilation, IVUS warranted the use of a larger balloon in five patients. After stent placement, incomplete stent apposition (n = 1), discrepancy between stent and reference lumen diameter (n = 3), and lesion distal to the stent (n = 2) seen on IVUS were treated with additional dilation in five patients and with a second stent in one patient. A larger balloon was used in three patients. Mean blood pressure and amount of antihypertensive drugs decreased (P < .05). CONCLUSIONS: In a number of patients, IVUS monitoring during renal artery stent placement resulted in additional lumen enlargement not considered necessary at angiography.",
keywords = "Hypertension, renal, Renal arteries, stenosis or obstruction, Stents and prostheses, Ultrasound (US), intravascular",
author = "Leertouwer, {Trude C.} and Gussenhoven, {Elma J.} and {Van Overhagen}, Hans and {Man In 'T Veld}, {Arie J.} and {Van Jaarsveld}, {Brigit C.}",
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Stent placement for treatment of renal artery stenosis guided by intravascular ultrasound. / Leertouwer, Trude C.; Gussenhoven, Elma J.; Van Overhagen, Hans; Man In 'T Veld, Arie J.; Van Jaarsveld, Brigit C.

In: Journal of Vascular and Interventional Radiology, Vol. 9, No. 6, 01.01.1998, p. 945-952.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Stent placement for treatment of renal artery stenosis guided by intravascular ultrasound

AU - Leertouwer, Trude C.

AU - Gussenhoven, Elma J.

AU - Van Overhagen, Hans

AU - Man In 'T Veld, Arie J.

AU - Van Jaarsveld, Brigit C.

PY - 1998/1/1

Y1 - 1998/1/1

N2 - PURPOSE: To study the impact of intravascular ultrasound (IVUS) during renal artery stent placement. MATERIALS AND METHODS: Patients (n = 22) with atherosclerotic renal artery stenosis were studied with IVUS after predilation and after angiographically successful stent deployment (diameter stenosis < 10%). After predilation, IVUS was used to assess whether the balloon size selected angiographically was correct (discrepancy balloon- reference lumen diameter < 20%). After stent placement, IVUS images were assessed for (i) complete stent-vessel wall apposition; (ii) complete stent expansion (discrepancy stent-reference lumen diameter < 20%), and (iii) complete lesion covering by the stent. Modification based on IVUS included selection of a larger balloon, additional dilation, and placement of a second stent. Clinical outcome was based on blood pressure, amount of antihypertensive drugs, and glomerular filtration rate during follow-up of 3 months. RESULTS: Stent placement and ultrasound imaging were completed successfully in 18 patients. After predilation, IVUS warranted the use of a larger balloon in five patients. After stent placement, incomplete stent apposition (n = 1), discrepancy between stent and reference lumen diameter (n = 3), and lesion distal to the stent (n = 2) seen on IVUS were treated with additional dilation in five patients and with a second stent in one patient. A larger balloon was used in three patients. Mean blood pressure and amount of antihypertensive drugs decreased (P < .05). CONCLUSIONS: In a number of patients, IVUS monitoring during renal artery stent placement resulted in additional lumen enlargement not considered necessary at angiography.

AB - PURPOSE: To study the impact of intravascular ultrasound (IVUS) during renal artery stent placement. MATERIALS AND METHODS: Patients (n = 22) with atherosclerotic renal artery stenosis were studied with IVUS after predilation and after angiographically successful stent deployment (diameter stenosis < 10%). After predilation, IVUS was used to assess whether the balloon size selected angiographically was correct (discrepancy balloon- reference lumen diameter < 20%). After stent placement, IVUS images were assessed for (i) complete stent-vessel wall apposition; (ii) complete stent expansion (discrepancy stent-reference lumen diameter < 20%), and (iii) complete lesion covering by the stent. Modification based on IVUS included selection of a larger balloon, additional dilation, and placement of a second stent. Clinical outcome was based on blood pressure, amount of antihypertensive drugs, and glomerular filtration rate during follow-up of 3 months. RESULTS: Stent placement and ultrasound imaging were completed successfully in 18 patients. After predilation, IVUS warranted the use of a larger balloon in five patients. After stent placement, incomplete stent apposition (n = 1), discrepancy between stent and reference lumen diameter (n = 3), and lesion distal to the stent (n = 2) seen on IVUS were treated with additional dilation in five patients and with a second stent in one patient. A larger balloon was used in three patients. Mean blood pressure and amount of antihypertensive drugs decreased (P < .05). CONCLUSIONS: In a number of patients, IVUS monitoring during renal artery stent placement resulted in additional lumen enlargement not considered necessary at angiography.

KW - Hypertension, renal

KW - Renal arteries, stenosis or obstruction

KW - Stents and prostheses

KW - Ultrasound (US), intravascular

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U2 - 10.1016/S1051-0443(98)70428-2

DO - 10.1016/S1051-0443(98)70428-2

M3 - Article

VL - 9

SP - 945

EP - 952

JO - Journal of Vascular and Interventional Radiology

JF - Journal of Vascular and Interventional Radiology

SN - 1051-0443

IS - 6

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