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Predictive value of duplex ultrasound for restenosis after renal artery stenting


Thalhammer, C; Ferriani, V; Husmann, M; Rufibach, K; Meier, T; Amann-Vesti, B R (2010). Predictive value of duplex ultrasound for restenosis after renal artery stenting. Clinical Hemorheology and Microcirculation, 45(2-4):217-224.

Abstract

Purpose: Factors predicting renal function and recurrent stenosis following percutaneous renal revascularization are poorly identified. The predictive value of hemodynamic duplex ultrasound (DUS) parameters was evaluated. Methods: In a prospective observational study patients undergoing stenting of renal artery stenosis (RAS) were included. Renal resistance index (RI) and peak systolic velocity (PSV) were measured at baseline, one day, and six months after intervention. Results: At 6-months follow-up 16 (16.8%) restenosis of 105 treated renal arteries were detected. Baseline RI was 0.69 +/- 0.12 and increased significantly to 0.72 +/- 0.09 after 6 months (p < 0.0001), however, RI did not predict restenosis. PSV at baseline and age were independent predictors for increased RI at 6 months (p = 0.0078 and p = 0.0019). Diabetics had a significant higher RI before revascularization (0.74 +/- 0.08) than non-diabetics (0.68 +/- 0.12, p = 0.04). PSV after stenting was higher in patients with restenosis (1.4 +/- 0.4 m/sec vs. 1.0 +/- 0.3 m/sec, p = 0.002) and was an independent predictor for restenosis. Conclusions: Increased PSV within the stent one day after the procedure is predictive for restenosis. Patients with high grade RAS and older patients have a worse outcome. DUS is recommended to detect patients at risk for restenosis after percutaneous renal revascularization.

Abstract

Purpose: Factors predicting renal function and recurrent stenosis following percutaneous renal revascularization are poorly identified. The predictive value of hemodynamic duplex ultrasound (DUS) parameters was evaluated. Methods: In a prospective observational study patients undergoing stenting of renal artery stenosis (RAS) were included. Renal resistance index (RI) and peak systolic velocity (PSV) were measured at baseline, one day, and six months after intervention. Results: At 6-months follow-up 16 (16.8%) restenosis of 105 treated renal arteries were detected. Baseline RI was 0.69 +/- 0.12 and increased significantly to 0.72 +/- 0.09 after 6 months (p < 0.0001), however, RI did not predict restenosis. PSV at baseline and age were independent predictors for increased RI at 6 months (p = 0.0078 and p = 0.0019). Diabetics had a significant higher RI before revascularization (0.74 +/- 0.08) than non-diabetics (0.68 +/- 0.12, p = 0.04). PSV after stenting was higher in patients with restenosis (1.4 +/- 0.4 m/sec vs. 1.0 +/- 0.3 m/sec, p = 0.002) and was an independent predictor for restenosis. Conclusions: Increased PSV within the stent one day after the procedure is predictive for restenosis. Patients with high grade RAS and older patients have a worse outcome. DUS is recommended to detect patients at risk for restenosis after percutaneous renal revascularization.

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4 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Epidemiology, Biostatistics and Prevention Institute (EBPI)
04 Faculty of Medicine > University Hospital Zurich > Clinic for Angiology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:July 2010
Deposited On:09 Aug 2010 11:20
Last Modified:05 Apr 2016 14:13
Publisher:IOS Press
ISSN:1386-0291
Publisher DOI:https://doi.org/10.3233/CH-2010-1300
Official URL:https://iospress.metapress.com/content/v08035358044817m
PubMed ID:20675902

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