Intravascular ultrasound in endovascular stent-grafts for peripheral aneurysm: a clinical study.
OBJECTIVE
To evaluate the potential diagnostic information of intraprocedural intravascular ultrasound (IVUS) in patients undergoing endovascular stent-grafting for peripheral aneurysm.


METHODS
IVUS was used in 17 patients preprocedurally to measure the diameter of the proximal and distal neck and the length of the aneurysm. Balloon and stent-graft sizes were selected based on these measurements. Following stent-graft deployment, angiography and IVUS were used to document stent apposition and the configuration and diameter of the stent-graft.


RESULTS
Stent-graft insertion was considered successful in 8 patients based on angiography and IVUS images. In 9 others, both imaging modalities showed inadequate results, necessitating 12 additional procedures: balloon angioplasty for stent-graft stenosis (2) and inadequate stent-graft apposition (1); an additional stent-graft (4); an extra stent (1); thrombectomy (2); and conversion (2) for inadequate stent-graft position and a graft rupture. In these patients, intraprocedural IVUS was superiorto angiography in contributing vital information to aid in the selection of the additional interventions.


CONCLUSIONS
During management of peripheral aneurysms with endovascular stent-grafts, IVUS monitoring was a useful adjunct when the initial procedure was unsatisfactory and/ or when intraprocedural angiographic studies were inconclusive.
van Sambeek
M R
MR
Department of Vascular Surgery, University Hospital Rotterdam-Dijkzigt, Erasmus University, Rotterdam, The Netherlands. vansambeek@hlkd.azr.nl
Gussenhoven
E J
EJ
van Overhagen
H
H
Honkoop
J
J
van der Lugt
A
A
du Bois
N A
NA
van Urk
H
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000000981:diagnostic imaging*; D019917:Blood Vessel Prosthesis Implantation; D002445:Celiac Artery / Q000000981:diagnostic imaging; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D015607:Stents; D018084:Ultrasonography, Interventional