title: Assessment of coronary artery stent restenosis by 64-slice multi-detector computed tomography.
abstract: OBJECTIVE
  We investigated the feasibility of assessing coronary artery stent restenosis using a new generation 64-slice multi-detector computed tomography-scanner (MDCT) in comparison to conventional quantitative angiography.
  
  
  RESULTS
  MDCT was performed in 64 consecutive patients (mean age 58+/-10 years) with previously implanted coronary artery stents (102 stented lesions: mean stent diameter 3.17+/-0.38 mm). Each stent was classified as 'evaluable' or 'unevaluable', and in evaluable stents, the presence of in-stent restenosis (diameter reduction >50%) was determined visually. Results were verified against invasive, quantitative coronary angiography. Fifty-nine stented lesions (58%) were classified as evaluable in MDCT. The mean diameter of evaluable stents was 3.28+/-0.40 mm, whereas the mean diameter of non-evaluable stents was 3.03+/-0.31 mm (P=0.0002). Overall, six of 12 in-stent restenoses were correctly detected by MDCT [50% sensitivity (confidence interval 22-77%)] and in 51 of 90 lesions, in-stent restenosis was correctly ruled out [57% specificity (46-67%)]. In evaluable stents, six of seven in-stent restenoses were correctly detected, and the absence of in-stent stenosis was correctly identified in 51 of 52 cases [sensitivity 86% (42-99%) and specificity 98% (88-100%)].
  
  
  CONCLUSIONS
  Stent type and diameter influence evaluability concerning in-stent restenosis by MDCT. The rate of assessable stents is low, but in evaluable stents, accuracy for detection of in-stent restenosis can be high.
authors.affiliation: Department of Internal Medicine 2 (Cardiology), University of Erlangen, Ulmenweg 18, 91054 Erlangen, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Rixe
authors.forename: Stephan
authors.initials: S
authors.lastname: Achenbach
authors.forename: Dieter
authors.initials: D
authors.lastname: Ropers
authors.forename: Ulrich
authors.initials: U
authors.lastname: Baum
authors.forename: Axel
authors.initials: A
authors.lastname: Kuettner
authors.forename: Ulrike
authors.initials: U
authors.lastname: Ropers
authors.forename: Werner
authors.initials: W
authors.lastname: Bautz
authors.forename: Werner G
authors.initials: WG
authors.lastname: Daniel
authors.forename: Katharina
authors.initials: K
authors.lastname: Anders
mesh_terms: D023903:Coronary Restenosis / Q000000981:diagnostic imaging*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D015607:Stents; D014057:Tomography, X-Ray Computed / Q000379:methods*