Original investigationAssessment of Coronary Artery Stent Patency and Restenosis Using 64-Slice Computed Tomography
Section snippets
Patient Population
The study population comprised 25 consecutive patients (23 male, 2 female; mean age 59.4 ± 12 years; range 40–83 years). Patients were included over a period of 4 months. Eligible patients had each undergone percutaneous transluminal coronary angioplasty with stent placement. After this interventional procedure, all patients underwent a second conventional coronary angiography and a comparative MSCT angiography of the coronary arteries. The mean time interval between MSCT and this second
MSCT Success Rate and Image Quality
MSCT was performed successfully in all 25 patients. According to the preliminary qualitative consensus analysis of the two MSCT readers, the examined stents were depicted with high image quality in 65% (30/46) of cases, moderate image quality in 33% (15/46) of cases, and poor image quality in 2% (1/46) of cases. The single case of poor image quality concerned a small (2.5 mm diameter) stent, which was uninterpretable on MSCT because of extensive metallic streak artifacts. Overall, the
Discussion
Follow-up examinations of patients after coronary artery stent placement is an important clinical issue in daily cardiology routine because of often very high rates of restenosis; restenosis rates of up to 46% have been reported during the first 6 months when non–drug-eluting stents are used (2, 3). The early detection of in-stent restenosis is crucial to avoid myocardial ischemia and to improve long-term prognosis: in-stent restenosis has a marked negative impact on the long-term survival of
Conclusion
The temporal and spatial resolution of interventional x-ray coronary angiography is still unmatched. However, the new generation of 64SCT scanners provides a significantly increased spatial and temporal resolution when compared to earlier MSCT systems. Our initial data raise the hope that in a clinical setting these benefits could be advantageous for the reliable, noninvasive diagnosis or exclusion of significant in-stent stenosis and the detection of significant peri-stent disease. Although
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Cited by (72)
Evaluation of coronary stents using multidetector CT
2016, Egyptian Journal of Radiology and Nuclear MedicineEvaluation of coronary artery stent patency by using 64-slice multi-detector computed tomography and conventional coronary angiography: A comparison with intravascular ultrasonography
2013, International Journal of CardiologyCitation Excerpt :Among the 87 stented segments, 79 were evaluable for ISDR by using MDCT with an overall evaluability of 91%; these findings were similar to those of recently published studies [2–5,8]. In contrast to other studies, our study revealed that factors such as stent diameter, strut thickness, stent material, stent type, and index vessel did not affect stent evaluation [4–6]. However, similar to our findings, the findings of the study conducted by Cademartiri et al. revealed no significant differences in the evaluability of stents with diameters greater than, equal to, and lesser than 3.0 mm3.
Agreement of duplex ultrasonography vs. computed tomography angiography for evaluation of native and in-stent SFA re-stenosis - Findings from a randomized controlled trial
2012, European Journal of RadiologyCitation Excerpt :However, while a number of studies have assessed the potential of CTA for the detection of steno-occlusive disease in native peripheral arteries, little has yet been reported on the potential of CTA for the assessment of intermediate- and long-term morphological success in these vessels after endovascular treatment. On the other hand, numerous studies have evaluated CTA for the determination of in-stent re-stenosis in other vascular territories such as the coronary arteries [5,6]. To date, most studies have utilized colour Doppler ultrasonography (CDUS) for follow-up assessment of the peripheral arterial vasculature after endovascular treatment [7].
Diagnostic accuracy of 64-slice multidetector CT for detection of in-stent restenosis in an unselected, consecutive patient population
2010, European Journal of RadiologyPredictors of image quality of coronary computed tomography in the acute care setting of patients with chest pain
2010, European Journal of RadiologyCitation Excerpt :This may be because our analysis included patients with history of stent placement (n = 10). All of these segments were classified as non-evaluable although there are a number of studies suggesting that stent imaging of proximal and large-sized stents may be feasible [23,24]. Overall, appropriate selection of subjects based on these findings may further decrease the number of non-evaluable segments.
Multidetector Computed Tomography Coronary Angiography for the Assessment of Coronary In-Stent Restenosis
2010, American Journal of CardiologyCitation Excerpt :Moreover, in addition to detector improvements, these scanners were equipped with much faster gantries, resulting in effective temporal resolution up to 83 ms.24,25,30 However, matrices with such thin layers required very high tube current and voltage,5–7,17–23,26–30 translating to radiation exposure increases.31,32 The studies using 64-slices scanners included in this review reported effective x-ray doses ranging from 10 and 20.5 mSv.5–8,17–23,26–29
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C.R. and F.v.Z. have contributed equally to this article.