title: Stent sizing by coronary computed tomographic angiography: comparison with conventional coronary angiography in an experienced setting.
abstract: OBJECTIVE
  The goal was to compare stent sizing by coronary computed tomographic angiography (CCTA) with that deployed in an experienced setting based upon conventional coronary angiography (CA).
  
  
  BACKGROUND
  Stent sizing is currently performed by visual estimation, with infrequent guidance by intravascular ultrasound. CCTA permits quantitative determination of stent length (Stent L) and diameter (Stent D).
  
  
  METHODS
  Projected L (CTA-Stent L) and D (CTA-Stent D) were determined from CCTA obtained in 248 patients with 352 lesions undergoing percutaneous coronary intervention within 4 months of the CCTA, and were compared to the Stent-L and Stent-D of the actually deployed stents. The effects of lesion modification and calcified plaque were also evaluated.
  
  
  RESULTS
  There were significant correlations between CTA-Stent L and Stent L (r = 0.656, P < 0.0001) and between CTA-Stent D and Stent D (r = 0.40, P < 0.001). Median predicted CTA-Stent L was slightly longer (20 mm vs. 18 mm, P < 0.0001) and predicted CTA-Stent D was slightly smaller (3.0 mm vs. 3.2 mm, P < 0.0001) than Stent-L and Stent-D, respectively. The differences were unchanged in stents with lesion modification by pre-dilation or intracoronary nitroglycerin. CTA Stent-L and CTA Stent-D increased significantly with increasing calcium (P < 0.0001 and P = 0.019, respectively).
  
  
  CONCLUSIONS
  (1) There are significant correlations between CCTA and CA based stent sizing in an experienced setting. (2) CCTA projects slightly longer and slightly smaller diameter stents than those deployed during PCI irrespective of lesion modification; the small differences are unlikely to have clinical significance. (3) CCTA may offer a noninvasive alternative to intravascular ultrasound for stent planning.
authors.affiliation: Lenox Hill Heart and Vascular Institute, New York, New York 10021, USA.
authors.forename: Ramesh
authors.initials: R
authors.lastname: de Silva
authors.forename: Christian J
authors.initials: CJ
authors.lastname: Mussap
authors.forename: Harvey S
authors.initials: HS
authors.lastname: Hecht
authors.forename: Nicolas M
authors.initials: NM
authors.lastname: van Mieghem
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Matarazzo
authors.forename: Gary S
authors.initials: GS
authors.lastname: Roubin
authors.forename: Georgia
authors.initials: G
authors.lastname: Panagopoulos
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D015607:Stents; D014057:Tomography, X-Ray Computed; D061205:Vascular Calcification / Q000000981:diagnostic imaging / Q000628:therapy