title: Multislice CT for assessing in-stent dimensions after left main coronary artery stenting: a comparison with three dimensional intravascular ultrasound.
abstract: OBJECTIVE
  To evaluate the agreement between multislice CT (MSCT) and intravascular ultrasound (IVUS) to assess the in-stent lumen diameters and lumen areas of left main coronary artery (LMCA) stents.
  
  
  METHODS
  Prospective, observational single centre study.
  
  
  METHODS
  A single tertiary referral centre.
  
  
  METHODS
  Consecutive patients with LMCA stenting excluding patients with atrial fibrillation and chronic renal failure.
  
  
  METHODS
  MSCT and IVUS imaging at 9-12 months follow-up were performed for all patients.
  
  
  METHODS
  Agreement between MSCT and IVUS minimum luminal area (MLA) and minimum luminal diameter (MLD). A receiver operating characteristic (ROC) curve was plotted to find the MSCT cut-off point to diagnose binary restenosis equivalent to 6 mm(2) by IVUS.
  
  
  RESULTS
  52 patients were analysed. Passing-Bablok regression analysis obtained a β coefficient of 0.786 (0.586 to 1.071) for MLA and 1.250 (0.936 to 1.667) for MLD, ruling out proportional bias. The α coefficient was -3.588 (-8.686 to -0.178) for MLA and -1.713 (-3.583 to -0.257) for MLD, indicating an underestimation trend of MSCT. The ROC curve identified an MLA ≤ 4.7 mm(2) as the best threshold to assess in-stent restenosis by MSCT.
  
  
  CONCLUSIONS
  Agreement between MSCT and IVUS to assess in-stent MLA and MLD for LMCA stenting is good. An MLA of 4.7 mm(2) by MSCT is the best threshold to assess binary restenosis. MSCT imaging can be considered in selected patients to assess LMCA in-stent restenosis.
authors.affiliation: Interventional Cardiology Unit, Heart Disease Institute, Hospital Universitari de Bellvitge, C/Feixa Llarga s/n, L'Hospitalet de Llobregat, Barcelona 08907, Spain. groura@bellvitgehospital.cat
authors.forename: Gerard
authors.initials: G
authors.lastname: Roura
authors.forename: Josep
authors.initials: J
authors.lastname: Gomez-Lara
authors.forename: José L
authors.initials: JL
authors.lastname: Ferreiro
authors.forename: Joan A
authors.initials: JA
authors.lastname: Gomez-Hospital
authors.forename: Rafael
authors.initials: R
authors.lastname: Romaguera
authors.forename: Luís M
authors.initials: LM
authors.lastname: Teruel
authors.forename: Elena
authors.initials: E
authors.lastname: Carreño
authors.forename: Enric
authors.initials: E
authors.lastname: Esplugas
authors.forename: Fernando
authors.initials: F
authors.lastname: Alfonso
authors.forename: Angel
authors.initials: A
authors.lastname: Cequier
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D057186:Comparative Effectiveness Research; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D023903:Coronary Restenosis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D003331:Coronary Vessels / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology; D011446:Prospective Studies; D012372:ROC Curve; D013030:Spain; D015607:Stents / Q000009:adverse effects*; D018084:Ultrasonography, Interventional / Q000379:methods / Q000706:statistics & numerical data