title: Coronary stent fracture: detection with 64-section multidetector CT angiography in patients and in vitro.
abstract: OBJECTIVE
  To evaluate 64-section multidetector coronary computed tomographic (CT) angiography for the depiction of coronary stent fracture in patients and in vitro.
  
  
  METHODS
  This retrospective study was approved by the institutional review board, and informed patient consent was waived. The coronary CT angiograms obtained in 371 consecutive patients (268 men, 103 women; mean age, 62.9 years) with 545 stents were reviewed. All patients with stent fractures underwent conventional coronary angiography and/or fluoroscopy as part of their medical care. In phantom studies, magnified radiographs of three types of drug-eluting stents in their fully expanded, maximally bent, and unrolled states were obtained. CT angiography and fluoroscopy of a water phantom that contained two drug-eluting stents--Cypher and Taxus devices--with four fractures each were performed, and two radiologists blinded to the fracture information evaluated the images.
  
  
  RESULTS
  Twenty-four stents with fractures were identified. Eighteen fractured stents (13 Cypher, four Taxus, one S670) in 14 patients were detected with CT angiography; six (33%; two Cypher, four Taxus) of these 18 stents in five (36%) patients were not detected on conventional angiograms at the initial readings. Six fractured stents showed significant (>50%) recurrent in-stent stenosis. Of 58 arteries with overlapping stent placements, eight (14%) had fractures involving 11 stents. In the in vitro studies, 57 stent fractures (31 Cypher, 26 Taxus) were detected with CT angiography and 38 (18 Cypher, 20 Taxus) were detected with fluoroscopy.
  
  
  CONCLUSIONS
  Coronary CT angiography depicts stent fractures in patients and phantoms, even those fractures that are not clearly depicted by conventional angiography.
  
  
  BACKGROUND
  http://radiology.rsnajnls.org/cgi/content/full/249/3/810/DC1.
authors.affiliation: Department of Diagnostic Radiology, Inje University Ilsanpaik Hospital, 2240 Daewha-dong, Goyang-si, Gyunggi-do 411-706, Korea.
authors.forename: Han Byeol
authors.initials: HB
authors.lastname: Lim
authors.forename: Gham
authors.initials: G
authors.lastname: Hur
authors.forename: Su Young
authors.initials: SY
authors.lastname: Kim
authors.forename: Yong Hoon
authors.initials: YH
authors.lastname: Kim
authors.forename: Sung Uk
authors.initials: SU
authors.lastname: Kwon
authors.forename: Won Ro
authors.initials: WR
authors.lastname: Lee
authors.forename: Soon Joo
authors.initials: SJ
authors.lastname: Cha
mesh_terms: D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D003331:Coronary Vessels; D054855:Drug-Eluting Stents; D004868:Equipment Failure; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D019047:Phantoms, Imaging; D012189:Retrospective Studies; D015607:Stents; D014057:Tomography, X-Ray Computed / Q000379:methods*