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

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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
Issue number6
Publication statusPublished - 1 Jan 1998


  • Hypertension, renal
  • Renal arteries, stenosis or obstruction
  • Stents and prostheses
  • Ultrasound (US), intravascular

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