Response of Renal and Femoropopliteal Arteries to Palmaz Stent Implantation Assessed with Intravascular Ultrasound

Abstract

Purpose:

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 follow-up 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.