Non-invasive evaluation of coronary artery stent patency with retrospectively ECG-gated 64-slice CT angiography |
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Authors: | Iacopo Carbone Marco Francone Emanuela Algeri Antonino Granatelli Alessandro Napoli Miles A Kirchin Carlo Catalano Roberto Passariello |
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Institution: | (1) Department of Radiological Sciences, University of Rome “La Sapienza”, Viale regina Elena 324, Rome, Italy;(2) San Giovanni Evangelista Hospital, Department of Cardiology, Tivoli (RM), Italy;(3) Worldwide Medical Affairs, Bracco Imaging, Milan, Italy |
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Abstract: | The aim of our study has been to evaluate the ability of 64-slice computed tomographic angiography (CTA) to assess coronary
artery stent patency, relative to selective coronary angiography (SCA). Fifty-five consecutive patients (age range 45–80 years)
with 97 previously implanted coronary artery stents underwent 64-slice CTA. The 55 patients comprised 40 subjects (group A)
who were referred for follow-up SCA at a mean interval of 9.6 months after stent positioning, and 15 subjects (group B) in
whom SCA was clinically indicated. Stent evaluation was performed independently by two blinded readers in terms of image quality
and presence of in-stent restenosis (ISR; lumen obstruction of ≥50%). SCA was performed in 41/55 patients; 14 patients refused
to undergo SCA after the 64-slice CTA exam. A total of 88 stents in 74 segments were analyzed. Twenty-one of the 74 stented
segments were of poor image quality and were not considered for further analysis. Sixty-four-slice CTA detected 12/16 ISR
(sensitivity: 75%) and ruled out ISR in 32/37 cases (specificity: 86%). Sixty-four-slice CTA is a valuable modality for follow-up
of coronary artery stent patency only in selected patients. Appropriate candidates for follow-up 64-slice CTA should be established
based on stent diameter, stent material and type as well as HR and heart rhythm. However, given the number of non-assessable
segments, further work would appear necessary before 64-slice CTA can be considered a suitable procedure for broad clinical
application in the evaluation of coronary artery stent patency. |
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Keywords: | Coronary artery Stents Multi-slice computed tomography Coronary restenosis Coronary angiography |
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