Intravascular Ultrasound Assessment of Iliac Stent Procedures

l l Purpose: To determine whether intravascular ultrasound (IVUS) is more sensitive in iden-tifying incomplete stent deployment or mechanical disruption compared to angiography. Methods: Over a 9-month period, 44 patients (25 men; mean age 63 years, range 36–88) treated for common or external iliac artery stenoses with balloon angioplasty and stenting underwent IVUS interrogation following completion arteriography. Results: One hundred nine stents were deployed in the 44 patients. Of these, 29 (27%) stents (in 45 % of patients) were found by IVUS to be incompletely deployed or to have an associated mechanical disruption despite a normal completion arteriogram. Further treat-ment (repeat dilation or additional stenting) was performed in 28 cases; 1 hemodynami-cally insignificant dissection was not treated. Twenty-six (93%) of these interventions were successful as determined by IVUS; 2 underexpanded stents did not respond to redilation. Conclusions: Incomplete stent deployment or mechanical problems associated with stent-ing were common in this study, occurring in nearly half of the patients. IVUS has clinical utility in identifying incomplete deployment or mechanical problems in stents with an increased sensitivity compared to contrast angiography. J Endovasc Ther 2000;7:315–319 Key words: peripheral arterial occlusive disease, Palmaz stent, Wallstent l l Percutaneous balloon angioplasty and stent-ing have been used with considerable suc-cess in the reconstruction of stenotic and oc-cluded iliac artery lumens for nearly 2 decades.1–3 For much of this time, assessment of the iliac artery following stent placement has relied on completion arteriography and the abolition of pressure gradients to deter-mine procedural success. However, contrast angiography has limitations that may result in failure to identify incomplete deployment of a stent or other mechanical defects that coul