Comparison between four-slice computed tomography and coronary angiography for the assessment of coronary stents.
BACKGROUND
The present study aimed to evaluate the diagnostic accuracy of four-slice computed tomography for the detection, localization and patency assessment of metal coronary stents in a general population referred for coronary angiography late after coronary angioplasty.


METHODS
Twenty-four consecutive patients with 34 coronary stents underwent multislice computed tomography within 24 h before a clinically driven coronary angiography performed 245 +/- 92 days after coronary stent implantation. For each patient, two independent operators were asked to evaluate the overall number of stents, the treated coronary vessels and segments, the presence of side-branches in the stented segment, the vessel patency, and the presence of binary in-stent restenosis.


RESULTS
Four-slice computed tomography was feasible in 23 out of 24 patients (96%). Diagnostic accuracy was 94% for stent detection, 96% for the recognition of the stented coronary vessel and 97% for the identification of the stented segment. Accuracy in detection of side-branches in the stented segment, vessel patency and in-stent restenosis was 86%, 88% and 50%, respectively.


CONCLUSIONS
Four-slice computed tomography is accurate in the identification of the stented coronary vessel and segment. By contrast, accuracy is low in the detection of vessel patency and in-stent restenosis. Such a technique does not appear to be useful as a screening tool before invasive diagnostic procedures.
Mazzarotto
Pietro
P
U O Cardiologia invasiva e interventistica endovascolare, Ospedale S Carlo-I D I, Rome, Italy. p.mazzarotto@idi.it
Di Renzi
Paolo
P
Paluello
Giovanni Minio
GM
Carunchio
Alessandro
A
Ricci
Roberto
R
Molisso
Antonio
A
Ceci
Vincenzo
V
Indolfi
Ciro
C
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D016477:Artifacts; D019917:Blood Vessel Prosthesis Implantation; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology; D011474:Prosthesis Design; D012107:Research Design; D012680:Sensitivity and Specificity; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014654:Vascular Patency