Response of renal and femoropopliteal arteries to Palmaz stent implantation assessed with intravascular ultrasound.
OBJECTIVE
To establish the processes responsible for late lumen loss in renal and femoropopliteal Palmaz stents using intravascular ultrasound (IVUS).


METHODS
The first 7 consecutive patients treated with stents for renal (n = 4) and femoropopliteal (n = 3) arterial occlusive disease were studied with IVUS immediately after angiographically successful stent placement (< 10% residual stenosis) and periodically during follow-up. Images of both stent edges and the most stenotic site inside the stent at followup were matched to the same cross sections captured immediately after stent placement for quantitative analysis.


RESULTS
Late lumen loss in renal artery stents at 5 to 34 months was considerably less than in femoropopliteal stents (17% versus 62%, respectively). In the renal location, late lumen loss (3.0 +/- 1.3 mm2) was due to neointimal hyperplasia, whereas stent area remained unchanged (3% decrease). Late lumen loss (7.4 +/- 8.2 mm2) in femoropopliteal stents was due to neointimal hyperplasia and stent area reduction (26%). Overall, in both types of arteries, neointimal development and stent area reduction were larger at the most stenotic site than at the stent edges.


CONCLUSIONS
These data suggest that there may be differences between renal and femoropopliteal arteries in the extent of hyperplastic response to stents.
Leertouwer
T C
TC
Department of Internal Medicine, Erasmus University Medical Center Rotterdam and ICIN, The Netherlands. leertouwer@tch.fgg.eur.nl
Gussenhoven
E J
EJ
van Lankeren
W
W
van Overhagen
H
H
D000792:Angiography; D000800:Angioplasty, Balloon / Q000295:instrumentation*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011150:Popliteal Artery / Q000000981:diagnostic imaging; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging / Q000628:therapy; D015607:Stents; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional