Multislice computed tomographic angiography versus digital subtraction angiography in the follow-up of nitinol stents in the superficial femoral artery.
OBJECTIVE
To compare quantitative and qualitative parameters obtained from digital subtraction angiography (DSA) with multislice computed tomographic angiography (MSCTA) in the follow-up of superficial femoral artery (SFA) stents.


METHODS
Thirteen patients who had SMART stents implanted in the SFA were examined systematically with DSA and MSCTA (16-row scanner) at 6 months. Quantitative analysis and morphological assessment were performed on DSA images by an independent core laboratory, while the MSCTA images were analyzed by 2 radiologists in consensus. DSA measurements included stent length, minimal lumen diameter and reference diameter at mid stent and 5 mm either side of the stent, and percentage of stenosis. For MSCTA images, lumen area and the minimum, maximum, and mean diameters were also recorded. The images were analyzed qualitatively for diameter stenosis (<50%, 50% to 70%, 71% to 99%, and occlusion), bends, fractures, and calcifications.


RESULTS
There were no statistical differences between lengths of stented segments, diameter measurements, or percentages of stenosis from DSA and MSCTA images. The Bland-Altman method showed good agreement between the 2 methods of measurement. MSCTA detected in-stent proliferation with a diameter stenosis <50% in all 13 cases diagnosed on DSA (there was no stenosis >50%). There were no bends or stent fractures on either set of images. The agreement between DSA and MSCTA for the presence and grading of calcifications was moderate (kappa=0.5).


CONCLUSIONS
MSCTA provided quantitative and qualitative data comparable with DSA in the analysis of SFA nitinol stents.
Willoteaux
Serge
S
Department of Cardiovascular Radiology, Hôpital Cardiologique, CHRU de Lille, France. s-willoteaux@chru-lille.fr
Moranne
Olivier
O
Duda
Stephan H
SH
Lions
Christophe
C
Gaxotte
Virginia
V
Durand
François
F
Negawi
Ziad
Z
Beregi
Jean-Paul
JP
D000368:Aged; D000369:Aged, 80 and over; D000497:Alloys; D015901:Angiography, Digital Subtraction; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011857:Radiographic Image Interpretation, Computer-Assisted; D012107:Research Design; D012720:Severity of Illness Index; D015607:Stents; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
D000497:Alloys; C013616:nitinol