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

Abstract

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. 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. 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. 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.