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British Journal of Radiology 75 (2002),879-883 © 2002 The British Institute of Radiology

Full paper

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

T C Gill-Leertouwer, MD1, E J Gussenhoven, MD2,4, J Deinum, MD3, L C van Dijk, MD1 and P M T Pattynama, MD1

Departments of 1 Radiology, 2 Cardiology and 3 Internal Medicine, Erasmus Medical Center, Rotterdam and 4 Interuniversity Cardiology Institute of The Netherlands, The Netherlands

Correspondence: Trude C Gill-Leertouwer, MD, PhD, Department of Radiology, University Hospital Rotterdam-Dijkzigt, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands

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 mm2 to 17±5.6 mm2 (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 mm2 to 29±9.3 mm2 (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; p=0.003). 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.






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