Detection of stent fractures: a comparison of 64-slice CT, conventional cine-angiography, and intravascular ultrasonography.
OBJECTIVE
We evaluated the ability of 64-slice computed tomography (CT), conventional cine-angiography, and intravascular ultrasound (IVUS) to detect stent fractures under ideal conditions. Coronary stent fracture has been implicated as one of the mechanisms of stent thrombosis and, perhaps, in-stent restenosis. However, the preferred imaging modality in detecting fractures in coronary stents has not been well established.


METHODS
Four different types of commonly used coronary stents (Cypher, Taxus, Vision, Hepacoat) each with three strut fractures (Cypher, 5; Taxus, 5; Vision, 4; Hepacoat, 5) were nominally deployed in polyurethane tubes and imaged with 64-slice CT, conventional cine-angiography, and IVUS. For each stent type, an unfractured control stent was also imaged.


RESULTS
Overall accuracy (84.1% vs. 73.9%), sensitivity (80.7 vs. 77.2%), and specificity (100% vs. 58.3%) for stent fracture detection was higher with 64 multislice CT compared to conventional cine-angiography. Stent fractures were not accurately detected by IVUS. Fracture detection by multislice CT was best when the stents were imaged at 45 degrees to the z-axis.


CONCLUSIONS
Under ideal in vitro conditions, CT has a high accuracy when used to evaluate coronary stent fractures. The overall accuracy, sensitivity, and specificity of detecting stent fractures are lower by conventional cine-angiography. Stent fractures were not detected using IVUS.
Pang
John H
JH
Division of Cardiology, Feinberg School of Medicine, Northwestern University, 676 N. Saint Clair, Suite 800, Chicago, IL 60611, USA.
Kim
David
D
Beohar
Nirat
N
Meyers
Sheridan N
SN
Lloyd-Jones
Donald
D
Yaghmai
Vahid
V
D001807:Blood Vessel Prosthesis; D002932:Cineangiography / Q000379:methods*; D017023:Coronary Angiography / Q000379:methods*; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000601:surgery; D019544:Equipment Failure Analysis / Q000379:methods*; D006801:Humans; D019047:Phantoms, Imaging; D015607:Stents; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014463:Ultrasonography / Q000379:methods*