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Role of color-Doppler sonography in the follow-up of renal artery stenting

Ruolo dell’eco-color Doppler nel monitoraggio dello stenting dell’arteria renale

  • Uro-Genital Radiology Radiologia Uro-Genitale
  • Published:
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Abstract

Purpose

The aim of this study was to evaluate the utility of color-Doppler ultrasound (CDUS) in detecting haemodynamically significant in-stent restenosis in patients who underwent endoluminal renal artery revascularisation by stent deployment.

Materials and method

Between January 2000 and December 2006, 42 patients (nine women and 33 men, age range 45–87 years) treated by endovascular renal artery stenting were studied with CDUS. Renal artery haemodynamics were evaluated to identify haemodynamically significant restenosis. Patients with CDUS signs of restenosis underwent angiography for a possible further revascularisation procedure.

Result

Of 42 patients examined by CDUS, 13 (31%) showed signs of haemodynamically significant in-stent renal artery restenosis. Of these 13, three did not undergo endoluminal renal artery revascularisation because renal ischaemia deterioration and irreversible renal circulation impairment. In the remaining ten patients (23.8%), who had no signs of severe nephropathy, angiography confirmed the CDUS findings of in-stent restenosis in all cases. Restenoses were successfully treated by a repeat endovascular revascularisation procedure.

Conclusion

Our results confirm the fundamental role of CDUS in the follow-up of patients after renal artery stenting. It enables early restenosis detection and evaluation of renovascular disease associated with renal artery stenosis. CDUS provides essential information for the subsequent clinical management of these patients.

Riassunto

Obiettivo

Valutare l’utilità dell’eco-color Doppler (ECD) nel rilevare precoci alterazioni flussimetriche indicative di ristenosi dell’arteria renale nel follow-up dei pazienti sottoposti a trattamento endovascolare di rivascolarizzazione mediante posizionamento di stent.

Materali e metodi

Nel periodo 2000–2006 sono stati studiati mediante ECD 42 pazienti (9 donne e 33 uomini, range 45–87 anni) portatori di stent dell’arteria renale. In tutti è stata valutata l’emodinamica dell’arteria renale tramite ECD allo scopo di evidenziare alterazioni emodinamicamente significative a livello dello stent. I pazienti con segni ECD di ristenosi sono stati sottoposti ad esame angiografico per eventuale ulteriore intervento di rivascolarizzazione.

Risultati

Dei 42 pazienti esaminati mediante ECD, 13 (31%) presentavano segni di ristenosi emodinamicamente significativa a livello dello stent. Di questi, 3 non sono stati sottoposti ad angiografia per peggioramento della nefropatia ischemica ed irreversibile compromissione emodinamica del circolo renale. Nei restanti 10 pazienti (23,8%), che non presentavano segni di severa nefropatia, il reperto ECD di ristenosi a livello dello stent è stato confermato in tutti i casi. Le restenosi sono state trattate con successo per via endovascolare.

Conclusioni

L’ECD svolge un ruolo fondamentale nel monitoraggio dei pazienti sottoposti a rivascolarizzazione dell’arteria renale mediante posizionamento di stent, consentendo una diagnosi precoce di ristenosi ed una valutazione della nefropatia spesso associata alla stenosi dell’arteria renale (SAR). L’ECD fornisce elementi essenziali alla successiva gestione terapeutica di questi pazienti.

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Authors and Affiliations

  1. U.O. Radiodiagnostica, OC “S. Maria delle Croci”, V.le Randi 5, 48100, Ravenna, Italy

    G. C. Parenti, D. Palmarini, M. Bilzoni & A. Ginevra

  2. Istituto di radiodiagnostica, Università degli Studi di Ferrara, Corso della Giovecca 203, 44100, Ferrara, Italy

    P. Campioni & P. Mannella

Authors
  1. G. C. Parenti
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  2. D. Palmarini
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  3. M. Bilzoni
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  4. P. Campioni
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  5. P. Mannella
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  6. A. Ginevra
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Correspondence to G. C. Parenti.

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Parenti, G.C., Palmarini, D., Bilzoni, M. et al. Role of color-Doppler sonography in the follow-up of renal artery stenting. Radiol med 113, 242–248 (2008). https://doi.org/10.1007/s11547-008-0240-2

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  • DOI: https://doi.org/10.1007/s11547-008-0240-2

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