Determination of stent stenosis: An in vivo experimental comparison of intravascular ultrasound and angiography with histology |
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Authors: | Karl Schürmann Dierk Vorwerk Robert Uppenkamp Bernd Klosterhalfen Arno Bücker Rolf W Günther |
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Institution: | (1) Department of Diagnostic Radiology, University of Technology, Pauwelsstrasse, D-52057 Aachen, Germany, DE;(2) Department of Pathology, University of Technology, Pauwelsstrasse, D-52057, Aachen, Germany, DE |
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Abstract: | Purpose: To compare intravascular ultrasound (IVUS) and angiography with histology in determining the degree of stent stenosis in
an in vivo experiment.
Methods: In 16 sheep, a total of 64 stents were implanted into the external iliac arteries. Two stents were inserted on either side.
Patency was followed by angiography and IVUS. Four types of stent were used: two Dacron-covered (Cragg Endopro and heparinized
Cragg Endopro) and two non-covered (Cragg and Memotherm stents). Eight animals were killed after 1 month, eight others after
6 months. Histological sections were prepared from the stented vessels. Measurements of the patent and total stent diameters
determined by IVUS, angiography, and histology were compared.
Results: Correlation between IVUS and angiography was 0.75, between IVUS and histology 0.77, and between angiography and histology
0.85. A mean stent stenosis of 17 ± 11% (range 0–51%) was found on angiography, of 10 ± 11% (0–46%) on IVUS, and of 20 ± 11%
(4%–49%) on histology. In comparison with histology, IVUS underestimated the degree of stenosis by 10 ± 8%, and angiography
underestimated it by 3 ± 6%. Resolution of IVUS was calculated to be about 0.35 mm and that of angiography to be about 0.15
mm.
Conclusion: Under experimental conditions, IVUS was not superior to angiography in determining the degree of stent stenosis in long-segment
stenoses of iliac artery stents, when measurements were correlated with histology. Angiography is sufficient for following
the patency of iliac artery stents. |
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Keywords: | : Stents and prostheses— Arteries— Intravascular ultrasound— Angiography— Neointima— Animal study |
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