Renal artery duplex ultrasound criteria for the detection of significant in‐stent restenosis

Conde, Ian Del; Galin, Ira; Trost, Biana; Kang, Jeanwan; Lookstein, R.; Woodward, Mark; Gustavson, Susan; Cambria, Richard P.; Jaff, Michael R.; Olin, Jeffrey W.

doi:10.1002/ccd.25270

Cited by 20 publications

(19 citation statements)

References 36 publications

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“…Chi et al [18], in a study of 67 patients with renal artery stents, found that a PSV of at least 395 cm/s or RAR of at least 5.1 was most predictive of significant in-stent stenosis. Similarly, Del Conde et al [19], in a study of 132 stented renal arteries, reported a mean PSV of 382 cm/s and RAR of 5.3 in arteries with >60% stenosis.…”

Section: Discussion Of Procedures By Variantmentioning

confidence: 75%

ACR Appropriateness Criteria® Renovascular Hypertension

Imaging¹,

Imaging²,

Harvin

et al. 2017

Journal of the American College of Radiology

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Renovascular hypertension is the most common type of secondary hypertension and is estimated to have a prevalence between 0.5% and 5% of the general hypertensive population, and an even higher prevalence among patients with severe hypertension and end-stage renal disease, approaching 25% in elderly dialysis patients. Investigation for renal artery stenosis is appropriate when clinical presentation suggests secondary hypertension rather than primary hypertension, when there is not another known cause of secondary hypertension, and when intervention would be carried out if a significant renal artery stenosis were identified. The primary imaging modalities used to screen for renal artery stenosis are CT, MRI, and ultrasound, with the selection of imaging dependent in part on renal function. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

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Section: Discussion Of Procedures By Variantmentioning

confidence: 75%

ACR Appropriateness Criteria® Renovascular Hypertension

Imaging¹,

Imaging²,

Harvin

et al. 2017

Journal of the American College of Radiology

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“…A periodic follow‐up duplex ultrasound is an accurate non‐invasive screening tool to detect ISR of renal stents . We could not perform a follow‐up renal arterial Doppler in case 4, as he was lost to follow up for some time.…”

Section: Discussionmentioning

confidence: 99%

Complex interventions of abdominal aorta and its branches in children with Takayasu arteritis: Clinical experience from a tertiary care center in north‐west India

et al. 2018

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Aim:To report our experience on complex percutaneous interventions of the abdominal aorta and its branches in six children with Takayasu arteritis (TA). Methods:A review of records of children with TA, who underwent percutaneous interventions of the abdominal aorta and its major branches. Results:In this analysis, we included six children with TA who underwent intervention of the abdominal aorta and its major branches. The endovascular interventions were performed mostly for treatment-resistant renovascular hypertension and mesentery artery ischemia. Mean age (±SD) at time of intervention was 10.6 ± 2.5 years (four boys and two girls). Percutaneous interventions included stenting of abdominal aorta (n = 2), renal arteries (n = 4), mesenteric arteries (n = 2), repeat stenting for renal artery in-stent restenosis (n = 1), and renal autotransplantation (n = 4). All 13 interventions were successful and enabled us to obtain good control of blood pressure. Conclusion:We hereby report six children with TA who were successfully managed with complex percutaneous interventions of the abdominal aorta and its major branches. Balloon dilatation and stent placement constitutes the mainstay of management of TA with stenosis of the large vessels. K E Y W O R D Sabdominal aorta, drug-eluting stent, hypertension, mesenteric artery stent, renal artery instent restenosis, renal artery stent, renal auto-transplantation, stent fracture, Takayasu arteritis

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“…They studied 67 patients stented for renal artery stenosis and compared them with 55 nonstented patients and determined that a PSV >395 cm/s or RAR >5.1 were most predictive of instent restenosis >70%. Lastly, Del Conde et al, 16 in 2014, established another set of velocity parameters to detect renal artery in-stent restenosis. A PSV <240 cm/s excluded significant in-stent restenosis (negative predictive value, 96%), a PSV $296 cm/s or RAR >4.4 was highly accurate for $60% stenosis (positive predictive value, 94% and 96%, respectively), and a PSV in the range of 241 to 296 cm/s indicated a "gray zone" that warranted further evaluation.…”

Section: Discussionmentioning

confidence: 99%

“…[6][7][8][9][10][11][12][13][14][15][16] The reported experience suggests that velocities in widely patent renal arteries with bare-metal stents tend to be higher than those in widely patent native renal arteries and that the use of velocity thresholds for stenosis in native renal arteries will overestimate the incidence of significant in-stent restenosis. 7,10,11,13,16 This difference has also been reported for native vs stented carotid arteries. [17][18][19][20] Some authors have attributed this observation to decreased arterial compliance in stented arteries.…”

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confidence: 99%

Renal duplex ultrasound findings in fenestrated endovascular aortic repair for juxtarenal aortic aneurysms

Heneghan

Starnes

Nathan

et al. 2016

Journal of Vascular Surgery

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Covered stent placement in nonstenotic renal arteries during FEVAR is safe and durable, with PSV and RAR remaining in the normal or <60% stenosis range in most patients. Increases in PSV or RAR that occur are not associated with clinically significant sequelae or in-stent stenosis on computed tomography angiography. DUS velocity criteria for stenosis in native renal arteries appear to overestimate the severity of stenosis in covered stents after FEVAR.

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Renal artery duplex ultrasound criteria for the detection of significant in‐stent restenosis

Cited by 20 publications

References 36 publications

ACR Appropriateness Criteria® Renovascular Hypertension

ACR Appropriateness Criteria® Renovascular Hypertension

Complex interventions of abdominal aorta and its branches in children with Takayasu arteritis: Clinical experience from a tertiary care center in north‐west India

Renal duplex ultrasound findings in fenestrated endovascular aortic repair for juxtarenal aortic aneurysms

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