Renal artery stenosis: Duplex US after angioplasty and stent placement

Abstract

PURPOSE: To evaluate the hemodynamic outcome of technically successful percutaneous transluminal renal artery angioplasty and stent placement (PTRAS) with duplex ultrasonography (US). MATERIALS AND METHODS: Eighteen patients who underwent PTRAS in 22 renal arteries were prospectively examined. All had abnormal preprocedural duplex US findings. Those who had significant renal artery stenosis (>70%) at angiography and underwent technically successful percutaneous interventions were enrolled. Standard intrarenal duplex US parameters (acceleration index [AI], acceleration time, waveform morphology grade, and resistive index) were compared before and after interventions. RESULTS: A significant AI increase occurred after PTRAS (9.02 m/sec2 ± 4.85 [SD]), as compared with before intervention (2.34 m/sec2 ± 2.03; P < .001). Acceleration time significantly decreased from 0.084 second ± 0.049 to 0.032 second ± 0.008 (P < .01). There was also a significant resistive index increase from 0.69 ± 0.12 to 0.79 ± 0.12 (P < .01). Abnormal waveform morphology (modified Halpern waveform grade 3-6) was present in 19 (86%) of 22 intrarenal arteries prior to intervention, as compared with one (5%) after PTRAS (P