Clinical success of renal artery stent placement is better for the treatment of hypertension than for preserving renal function. In patients with renal function impairment, lateralization to the affected kidney on the scintigram appears to be a predictor of clinical success.

Clinical success of renal artery stent placement is better for the treatment of hypertension than for preserving renal function. In patients with renal function impairment, lateralization to the affected kidney on the scintigram appears to be a predictor of clinical success.

Abstract. The objective of this study was to determine the quantitative intravascular ultrasound (IVUS) and angiographic changes that occur during 1 year follow-up after renal artery stent placement, given that restenosis continues to be a limitation of renal artery stent placement. 38 consecutive patients with symptomatic renal artery stenosis treated with Palmaz stent placement were studied prospectively. IVUS and angiography were performed at the time of stent placement and at 1 year follow-up. At follow-up, angiographic restenosis was seen in 14% of patients. The lumen area in the stent, seen with IVUS, was significantly decreased from 24¡5.6 mm 2 to 17¡5.6 mm 2 (p,0.001) solely due to plaque accumulation. The distal main renal artery showed a significant decrease in lumen area owing to a significant vessel area decrease from 39¡14.0 mm 2 to 29¡9.3 mm 2 (p,0.001) without plaque accumulation. Angiographic analysis confirmed this reduction in luminal diameter and showed that the distal renal artery diameter at follow-up was significantly smaller than before stent placement (86¡23.0% vs 104¡23.9% of the contralateral renal artery diameter; p50.003). Besides plaque accumulation in the stent, unexplained shrinkage of the distal main renal artery was evidenced with IVUS and angiography 1 year following stent placement.Stent placement is in common use for the revascularization of renal artery stenosis (RAS). However, restenosis after renal artery stent placement continues to be a problem, with reported restenosis rates in up to 39% of patients at 8 months followup [1]. In order to characterize the restenotic process we used intravascular ultrasound (IVUS) as an adjunct to standard angiography, because IVUS provides accurate data on vessel and plaque dimensions that allows monitoring of changes that occur over time in the treated vessel.The aim of the present study was to determine the quantitative IVUS and angiographic changes in the renal artery seen at 1 year follow-up in a series of consecutive patients who underwent renal artery stenting for atherosclerotic RAS. Methods PatientsBetween September 1996 and December 1998, 41 consecutive patients (27 men, 14 women; aged 60¡9 years (mean¡standard deviation unless stated)) presenting with symptomatic RAS of ¢50% diameter stenosis were treated with stent placement. One patient underwent stenting of both renal arteries on two separate occasions, therefore, a total of 42 renal arteries were treated. Patients had renal function impairment (serum creatinine ¢110 mmol l 21