Usefulness of multislice computed tomography to assess patency of coronary artery stents versus conventional coronary angiography.
BACKGROUND
The aim of the present study was to assess the in-stent restenosis and occlusion of coronary artery stents by multislice computed tomography (MSCT) compared with conventional coronary angiography in patients with atypical chest pain and not practicable/non-conclusive stress test.


METHODS
Between December 2004 and March 2006, 81 patients were scheduled and of these 72 (65 men, mean age 61 years) with 90 stents underwent MSCT angiography using a 16-slice scanner, Toshiba Aquilion 16, 8-12 months after stent placement.


RESULTS
Of the 90 stents, 71 (79%) could be assessed and 19 (21%) were excluded because the image quality at the stent level was incompatible with diagnostic assessment. This results in sensitivity, specificity, and positive and negative predictive values for all assessable stents in the identification of occlusion and/or in-stent restenosis of 82, 96, 87, and 94%, respectively. When the 19 uninterpretable stents were included in the analysis, the diagnostic accuracy of MSCT in detecting in-stent restenosis and occlusion resulted in a sensitivity of 82%, specificity of 71%, positive predictive value of 40%, and negative predictive value of 94%.


CONCLUSIONS
The results of the study suggest that MSCT angiography is a useful method for evaluating patency/occlusion of large (>or=3 mm) coronary stents in symptomatic patients with atypical chest pain and concomitant not practicable/non-conclusive exercise or stress imaging test.
Tedeschi
Carlo
C
Cardiology Unit, San Gennaro Hospital, ASL Napoli 1, Naples, Italy. carlo.tedeschi@hotmail.it
Ratti
Gennaro
G
De Rosa
Roberto
R
Sacco
Maurizio
M
Borrelli
Francesco
F
Tammaro
Paolo
P
Covino
Gregorio
G
Montemarano
Emilio
E
Cademartiri
Filippo
F
Runza
Giuseppe
G
Midiri
Massimo
M
Pepe
Roberto
R
Tuccillo
Bernardino
B
Capogrosso
Paolo
P
D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging*; D003331:Coronary Vessels; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D015607:Stents; D014057:Tomography, X-Ray Computed