Non-invasive assessment of coronary artery stent patency with multislice CT: preliminary experience.


PURPOSE To evaluate the diagnostic accuracy of multislice computed tomography coronary angiography (MSCT-CA) in the detection of in-stent restenosis. MATERIALS AND METHODS Forty-two patients (33 male, 9 female, mean age 58+/-8 years) previously subjected to percutaneous implantation of coronary stent with suspected in-stent restenosis, underwent a 16-row MSCT (Sensation 16, Siemens) examination. The average time between stent implantation and MSCT-CA was 7.4+/-5.3 months. The following scan parameters were used: collimation 16x0.75 mm, rotation time 0.42 s, feed 3.0 mm/rot., kV 120, mAs 500. After administration of iodinated contrast material (Iomeprol 400 mgI/ml, 100 ml at 4 ml/s) and bolus chaser (40 ml of saline at 4 ml/s) the scan was completed in <20 s. All segments with a stent were assessed by two observers in consensus and were graded according to the following scheme: patent stent, in-stent intimal hyperplasia (IIH) (lumen reduction <50%), in-stent restenosis (ISR) (=/>50%), in-stent occlusion (ISO) (100%). Consensus reading was compared with coronary angiography. RESULTS Forty-seven stents were assessed (16 in the right coronary artery; 4 in the left main; 22 in the left anterior descending; 5 in the circumflex). In 7 (17%) stents there was ISR (3) or ISO (4), and in 4 (10%) stents there was IIH. The sensitivity and negative predictive values for the detection of ISO were 80% and 98%, respectively, while for the detection of ISR+ISO they were 50% and 89%, respectively. CONCLUSIONS Although the results are encouraging, the follow-up of stent patency with MSCT-CA does not show a diagnostic accuracy suitable for clinical implementation.


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@article{Cademartiri2005NoninvasiveAO, title={Non-invasive assessment of coronary artery stent patency with multislice CT: preliminary experience.}, author={Filippo Cademartiri and Riccardo Marano and Giuseppe Runza and Nico Mollet and K. Nieman and G. Luccichenti and Massimo Gualerzi and Lorenzo Brambilla and Paolo Coruzzi and Massimo Galia and Massimo Midiri}, journal={La Radiologia medica}, year={2005}, volume={109 5-6}, pages={500-7} }