title: Carotid artery stenting and follow-up: value of 64-MSCT angiography as complementary imaging method to color-coded duplex sonography.
abstract: OBJECTIVE
  To compare 64-multi-slice-CT angiography (64-MSCTA) to color-coded duplex sonography (CCDS) in the follow-up after carotid artery stenting (CAS).
  
  
  METHODS
  Thirty patients who had an MSCTA and CCDS examination prior and after CAS were included. Twelve closed-cell and 24 open-cell stents were implanted. Neointimal surface, in-stent-restenosis (ISR), stent expansion, and fracture were evaluated. In addition, the occurrence of atherosclerotic lesions leading to a>50% stenosis in supraaortic vessels was assessed.
  
  
  RESULTS
  With MSCTA, >50% ISR was found in 5.6% of cases during a mean follow-up of 41.7 months. Comparing MSCTA and CCDS, grading of ISR and absolute diameters of neointimal surface correlated moderately (Spearman=0.402, p=0.015; Pearson=0.404, p=0.03). Assessment of the neointimal surface was significantly better with MSCTA (100% vs. 80.6%; p=0.011). Stent expansion was significant, compared to the basic value, with both modalities and stent types (p<0.001). Of 237 additionally assessed vessel segments, a>50% stenosis was detected in 38 (16.0%) vessel segments. Findings were stable in 25 (10.5%) and progressed in 11 (4.6%) vessel segments. Five small intracranial aneurysms were detected in four (13.3%) patients. Of 21 incidental findings in 16 (51.6%) patients there was one with malignancy (4.8%).
  
  
  CONCLUSIONS
  With regard to ISR and stent expansion, no significant difference was found, when MSCTA and CCDS were compared. CTA is quite applicable as a complementary imaging method for the follow-up of patients with carotid artery stents. Additional advantages are the detection of supraaortic vessel pathologies and incidental findings.
authors.affiliation: Department of Radiology, Division of Cardiovascular and Interventional Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria. richard.nolz@meduniwien.ac.at
authors.forename: Richard
authors.initials: R
authors.lastname: Nolz
authors.forename: Andreas
authors.initials: A
authors.lastname: Wibmer
authors.forename: Dietrich
authors.initials: D
authors.lastname: Beitzke
authors.forename: Stephan
authors.initials: S
authors.lastname: Gentzsch
authors.forename: Andrea
authors.initials: A
authors.lastname: Willfort-Ehringer
authors.forename: Johannes
authors.initials: J
authors.lastname: Lammer
authors.forename: Majda
authors.initials: M
authors.lastname: Thurnher
authors.forename: Maria
authors.initials: M
authors.lastname: Schoder
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D016893:Carotid Stenosis / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted; D015607:Stents / Q000009:adverse effects*; D013382:Subtraction Technique; D014057:Tomography, X-Ray Computed / Q000379:methods*; D018615:Ultrasonography, Doppler, Color / Q000379:methods*