Objective: To assess whether intravascular ultrasound (IVUS), used systematically in a series of patients with abdominal aortic aneurysms (AAA), is a feasible control procedure to ensure correct transfemoral placement of endovascular stent grafts (TPEG).
Design: Descriptive study.
Materials and methods: Fourteen patients with infrarenal aortic aneurysms were treated by the placement of one tube graft, 10 aorto-uni-iliac and three aorto-bi-iliac grafts. Arteriography and IVUS were performed before, during and after deployment of the graft to ensure correct placement in relation to side branches, and proper adaptation of the stents to the aortic wall. Postoperative CT-scan and arteriography served as control procedures.
Results: IVUS identified both renal arteries before graft deployment in eight of 13 (62%) patients. In the remaining patients only one renal artery was visualised due to interference from guidewires or the introducer system. Imaging during stent deployment was abandoned after IVUS catheter damage in two of three cases. Postprocedural IVUS was able to evaluate the expansion of the stents and the adaptation to the aortic wall in all instances. In four (29%) cases a leak was identified. Additional intervention included deployment of a further stent (n = 2) or redilation (n = 2). Covering of the renal arteries could only be indirectly determined by IVUS.
Conclusion: IVUS can provide important decisive information before and after stented graft deployment, with the limitations that guidewires, introducer system and stents may cause interference. Contemporary IVUS designs are unsuitable for monitoring stent deployment.