Duplex ultrasonography in assessing restenosis of renal artery stents

• Published in: Cardiovascular and interventional radiology Vol. 22; no. 6; pp. 475 - 480
• Main Authors: BAKKER, J, BEUTLER, J. J, ELGERSMA, O. E. H, DE LANGE, E. E, DE KORT, G. A. P, BEEK, F. J. A
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer 01.11.1999; Berlin Springer Nature B.V
• Subjects: ACCURACY; Aged; Angiography; Angiography, Digital Subtraction; AORTA; Arteries; Biological and medical sciences; BIOMEDICAL RADIOGRAPHY; Diseases of the cardiovascular system; Female; Humans; Implants; KIDNEYS; Male; Medical imaging; Medical sciences; PATIENTS; Prospective Studies; RADIOLOGY AND NUCLEAR MEDICINE; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Recurrence; Renal artery; Renal Artery - diagnostic imaging; Renal Artery Obstruction - diagnostic imaging; Renal Artery Obstruction - therapy; Restenosis; ROC Curve; SENSITIVITY; Sensitivity and Specificity; SPECIFICITY; Stents; ULTRASONOGRAPHY; Ultrasonography, Doppler, Duplex; United States > US; Sonography; Human; Restenosis; Endoprosthesis; Prognosis; Treatment; Renal artery; Instrumentation therapy; Medical imagery; Instrumental dilatation; Duplex ultrasonography
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s002709900435

To determine the accuracy and optimal threshold values of duplex ultrasonography (US) in assessing restenosis of renal artery stents. Twenty-four consecutive patients with 33 renal arteries that had previously been treated with placement of a Palmaz stent underwent duplex US prior to intraarterial digital subtraction angiography (DSA), which was the reference standard. Diagnostic accuracy of in-stent peak systolic velocity (PSV) and reno-aortic ratio (RAR = PSV renal stent/PSV aorta) in detecting > 50% in-stent restenosis were evaluated by the receiver operating characteristic curve. Sensitivity and specificity were determined using the optimal threshold values, and using published threshold values: RAR > 3.5 and in-stent PSV > 180 cm/sec. Six examinations were technically inadequate. Nine stents had residual or restenosis > 50% at DSA. The two duplex parameters were equally accurate since areas under the curves were similar (0.943). With optimal threshold values of 226 cm/sec for PSV and 2.7 for RAR, sensitivities and specificities were 100% and 90%, and 100% and 84%, respectively. Using the published duplex criteria resulted in sensitivities and specificities of 100% and 74% for PSV, and 50% and 89% for RAR. Duplex US is a sensitive modality for detecting in-stent restenosis if laboratory-specific threshold values are used.