Hans Peter Weskott MD, Presenter: Nothing to Disclose

Thomas Fuerste MD, Abstract Co-Author: Nothing to Disclose

Zera Bastuerk-Beyaz MD, Abstract Co-Author: Nothing to Disclose

Enz-Ruediger von Leitner, Abstract Co-Author: Nothing to Disclose

Evaluation of long term patency after ICA stenting by calculating the perfused residual lumen and peak velocities using B-Mode, CDI, PW Doppler and B-Flow®

After PTA and stenting in 53 patients with 61 ICA stenoses, long term monitoring was applied by using B-mode, CDI, PW Doppler and B-Flow® (10L Probe, LOGIQ 7, GE, MI, USA). Using B-mode and B-Flow, vessel lumen areas were calculated at 90deg cross section images, the local degree of stenosis was calculated (perfused lumen compared to total stented area). CDI and PW-Doppler were performed at long axis views, angle ≤ 60deg. Follow up started within the first days, 3-6 months and then yearly up to 63 months after intervention. Results were compared to a control group of gender and age matched healthy subjects (n=15 males, 15 females, 50-80yrs).

Due to severe calcification in 8 pts, ultrasound did not allow sufficient lumen imaging after stenting. In most pts B-Mode could not demonstrate the thickened echopoor to echofree neointima. Due to blooming CDI could not image the true residual lumen, except in three cases of higher degree of stenoses (60%-82%). Control group, B-Flow: male 0.17±0.02cm² (mean±SD), female 0.15±0.01cm². Mean area of the narrowest stented ICA section: B-Mode: 0.14±0.05cm², B-Flow perfused portion: 0.12±0.04cm². In comparison to the control group 10 pts had a greater perfused lumen (+13.4±9.3%), 11 pts an equal lumen, 32 pts a smaller lumen (-38.3±20.9%), 12 exceeded 50% (B-Flow images). All in-stent restenoses were caused by an echopoor mostly eccentric located tissue. Mean degree of restenosis was 18.0±22.0%, 4 exceeded 50%, 1 exceeded 70%. PW Doppler did not correlate to the degree stenosis below 50%. None of the treated pts developed neurological symptoms during follow up.

B-Flow seems to be the most sensitive non invasive US technique in displaying in-stent restenosis non-invasively. No significant progression of in-stent stenosis was seen beyond 6 months after stenting.

Weskott, H, Fuerste, T, Bastuerk-Beyaz, Z, von Leitner, E, Long-term Follow-up after ICA Stenting Using B-Mode Ultrasound, B-Flow®, Color, and Pulse Wave Doppler Techniques.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4406576.html