Assessment of coronary artery stent restenosis by 64-slice multi-detector computed tomography.
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.
Rixe
Johannes
J
Department of Internal Medicine 2 (Cardiology), University of Erlangen, Ulmenweg 18, 91054 Erlangen, Germany.
Achenbach
Stephan
S
Ropers
Dieter
D
Baum
Ulrich
U
Kuettner
Axel
A
Ropers
Ulrike
U
Bautz
Werner
W
Daniel
Werner G
WG
Anders
Katharina
K
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*