title: Noninvasive assessment of coronary in-stent restenosis by dual-source computed tomography.
abstract: Assessment of coronary artery stents using computed tomographic angiography has been challenging. The technology of dual-source computed tomography (DSCT) provides higher temporal resolution that may allow more accurate evaluation of coronary stents. This study evaluated the accuracy of DSCT for the assessment of coronary artery in-stent restenosis. A total of 112 patients with 150 previously implanted coronary stents (diameter > or = 3.0 mm) were examined using DSCT (Definition; Siemens Medical Solutions, Forchheim, Germany) before conventional coronary angiography. Each stent was classified as assessable or not assessable. All assessable stents were further classified for the absence or presence of in-stent restenosis (>50% diameter reduction) using DSCT, and results were compared with those using quantitative coronary angiography. Mean stent diameter was 3.27 +/- 0.35 mm. Fifteen of 80 stents (19%) with a diameter of 3.0 mm were not assessable, and all 70 stents >3.0 mm were assessable. DSCT correctly identified 16 of 19 in-stent restenoses in 135 assessable stents, as well as the absence of in-stent restenosis in 110 of 116 stents (sensitivity 84%, specificity 95%, positive predictive value 73%, and negative predictive value 97% in assessable stents). In conclusion, DSCT may be useful to noninvasively detect in-stent restenosis, especially in stents with a relatively large diameter.
authors.affiliation: Department of Internal Medicine 2 (Cardiology), University of Erlangen-Nuremberg, Erlangen, Germany. tobiaspflederer@web.de
authors.forename: Tobias
authors.initials: T
authors.lastname: Pflederer
authors.forename: Mohamed
authors.initials: M
authors.lastname: Marwan
authors.forename: Alexandra
authors.initials: A
authors.lastname: Renz
authors.forename: Sven
authors.initials: S
authors.lastname: Bachmann
authors.forename: Dieter
authors.initials: D
authors.lastname: Ropers
authors.forename: Axel
authors.initials: A
authors.lastname: Kuettner
authors.forename: Katharina
authors.initials: K
authors.lastname: Anders
authors.forename: Fabian
authors.initials: F
authors.lastname: Bamberg
authors.forename: Werner G
authors.initials: WG
authors.lastname: Daniel
authors.forename: Stephan
authors.initials: S
authors.lastname: Achenbach
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*