Coronary stent assessability by 64 slice multi-detector computed tomography.
BACKGROUND
We evaluated the assessability of contemporary stent platforms by 64-slice multi-detector computed tomography (MDCT).


METHODS
Patients undergoing coronary stenting were included in a prospective protocol of MDCT imaging within 48 hr of stent implantation. MDCT data were acquired using a "Sensation 64" MDCT scanner (Siemens Medical Solutions, Forchheim, Germany). Stent assessability was assessed by two independent blinded observers and disagreement was resolved by a third observer. Assessability was defined at visualization of the in-stent lumen without influence of partial volume effects, beam hardening, motion, calcification, or contrast to noise limitations.


RESULTS
Fifty four stents (Cypher n = 25, Vision/Minivision n = 19, Taxus Express n = 8, Liberte n = 1, Driver n = 1) in 44 patients were included in the study. The two independent observers classified 30 of 54 stents (56%) as assessable. Interobserver reproducibility was good with kappa = 0.66. Stent size was the most important determinant of assessability. Consistently assessable stents were 3.0 mm or larger (85%), whereas those under 3 mm were mostly nonassessable (26%).


CONCLUSIONS
Contemporary stent designs evaluated on a 64-slice MDCT scanner showed artifact free assessability only in larger stents. Increase in spatial resolution of MDCT scanners or modifications in stent design will be necessary to noninvasive evaluate stents <3 mm in diameter, where in-stent restenosis is more frequent.
Sheth
Tej
T
Cardiac MR-PET-CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA. shetht@mcmaster.ca
Dodd
Jonathan D
JD
Hoffmann
Udo
U
Abbara
Suhny
S
Finn
Aloke
A
Gold
Herman K
HK
Brady
Thomas J
TJ
Cury
Ricardo C
RC
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D016477:Artifacts; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D023903:Coronary Restenosis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D008875:Middle Aged; D015588:Observer Variation; D011446:Prospective Studies; D011474:Prosthesis Design; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results; D012107:Research Design; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014654:Vascular Patency