Stent Placement for Treatment of Renal Artery Stenosis Guided by Intravascular Ultrasound

Leertouwer, Trude C.; Gussenhoven, Elma J.; Overhagen, Hans van; Veld, A. J. Man In 'T; Jaarsveld, Brigit C. van

doi:10.1016/s1051-0443(98)70428-2

Cited by 26 publications

(16 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Increased wall shear stress will induce an adaptation process of the vessel wall mediated by nitric oxide [10], which may result in vessel dilatation both immediately after stent placement and at follow-up. After stent placement this agreed both with data previously presented by others [8] and with our previously presented findings that pre-dilatation and stent placement resulted in enlargement of the distal renal artery [3]. At follow-up, however, shrinkage of the distal renal artery instead of dilatation was experienced.…”

Section: Discussionsupporting

confidence: 92%

“…The in-stent restenosis rate of 14% in the present study was similar to the 19% restenosis rate reported in a series of 100 renal stent patients by White et al [8]. It should be acknowledged that the favorable restenosis rate in the present study may be related to the use of IVUS during the stent placement procedure; previously we showed that in 33% of patients, additional dilatation or stent placement was warranted to achieve accurate stent placement [3]. However, a randomized study is required to assess the true beneficial role of IVUS on longterm stent patency.…”

Section: Discussionsupporting

confidence: 89%

“…A Palmaz stent (Johnson & Johnson Interventional Systems, New York, NY) was then placed (p104 (10.4 mm stent length), p154 (15.4 mm) or p204 (20.4 mm) stents). Stent placement was considered technically successful when post-procedural IVUS and angiography showed complete stent-vessel wall apposition, complete lesion covering and a ,20% residual diameter stenosis [3]. When necessary, additional stent dilatation was performed using a 6 mm or 7 mm balloon.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Shrinkage of the distal renal artery 1 year after stent placement as evidenced with serial intravascular ultrasound

Gill-Leertouwer¹,

Gussenhoven²,

Deinum³

et al. 2002

BJR

View full text Add to dashboard Cite

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

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 89%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Shrinkage of the distal renal artery 1 year after stent placement as evidenced with serial intravascular ultrasound

Gill-Leertouwer¹,

Gussenhoven²,

Deinum³

et al. 2002

BJR

View full text Add to dashboard Cite

show abstract

“…Furthermore, after PTRA, IVUS aided in evaluating the adequacy of the implanted stent location and the occurrence of adverse events such as dissection or inadequate expansion. 15,16 In this case, we performed adequate stent implantation without recoiling or dissection.…”

Section: Discussionmentioning

confidence: 96%

Percutaneous Transluminal Renal Angioplasty Remarkably Improved Severe Hypertension and Renal Function in a Patient with Renal Artery Stenosis and Postrenal Kidney Failure

et al. 2013

View full text Add to dashboard Cite

A 69-year-old man was admitted to our hospital with severe hypertension and rapidly worsening renal function. He presented with a 10-year history of chronic renal failure caused by bilateral ureteral obstruction due to retroperitoneal fibrosis. Magnetic resonance angiography and Doppler ultrasonography suggested severe right renal artery stenosis (RAS). Renal angiography revealed 99% stenosis at the ostium of the right renal artery. We performed percutaneous transluminal renal angioplasty (PTRA) with the support of intravascular ultrasound to decrease the amount of contrast agent needed. In addition, to prevent distal atheroembolism, a distal protection device was used. The procedure was completed without any adverse effects. After PTRA, renal function and blood pressure improved remarkably and remained stable for one year. PTRA for RAS remains controversial, especially in patients with renal insufficiency. Use of new devices should be considered to decrease catheterization-related adverse effects.

show abstract

“…[31][32][33] Inadequate stent-to-vessel wall apposition, which may occur in as many as 33% of cases as demonstrated by intravascular ultrasound, is also associated with higher rates of renal ISR. 34 The occurrence of renal ISR can be minimized by maximizing stent diameter with the use of devices (eg, intravascular ultrasound) that optimize stent expansion to Ն6 mm.…”

Section: Treatment Of Renal Isrmentioning

confidence: 99%

Atherosclerotic Peripheral Vascular Disease Symposium II

Rocha‐Singh

Eisenhauer²,

Textor

et al. 2008

Circulation

View full text Add to dashboard Cite

Stent Placement for Treatment of Renal Artery Stenosis Guided by Intravascular Ultrasound

Cited by 26 publications

References 25 publications

Shrinkage of the distal renal artery 1 year after stent placement as evidenced with serial intravascular ultrasound

Shrinkage of the distal renal artery 1 year after stent placement as evidenced with serial intravascular ultrasound

Percutaneous Transluminal Renal Angioplasty Remarkably Improved Severe Hypertension and Renal Function in a Patient with Renal Artery Stenosis and Postrenal Kidney Failure

Atherosclerotic Peripheral Vascular Disease Symposium II

Contact Info

Product

Resources

About