title: Coronary stent evaluation with coronary computed tomographic angiography: comparison between low-osmolar, high-iodine concentration iomeprol-400 and iso-osmolar, lower-iodine concentration iodixanol-320.
abstract: BACKGROUND
  Reliability of coronary angiography by multidetector row CT (MDCT-CA) for stent evaluation is still a matter for debate, and it is unknown whether contrast medium characteristics may affect diagnostic performance of MDCT-CA.
  
  
  OBJECTIVE
  We compared iomeprol-400 with iodixanol-320 to evaluate coronary stents with MDCT-CA.
  
  
  METHODS
  We randomly assigned 254 patients undergoing coronary stent follow-up with the use of MDCT-CA to iomeprol-400 at 5.0 mL/sec flow rate (group 1; n = 83), iodixanol-320 at 6.2 mL/sec flow rate (group 2; n = 87), and iodixanol-320 at 5.0 mL/sec flow rate (group 3; n = 84). Heart rate (HR) immediately before and at the end of scanning, HR variation, premature heart beats, and heat sensation by visual analog scale during scanning were recorded. Mean attenuation was measured in the aortic root and coronary arteries. Image quality score and type of artifacts were assessed.
  
  
  RESULTS
  Mean attenuation was significantly lower in group 3 than in the other groups. In group 3, stent evaluability was significantly higher and artifact rate was significantly lower than in group 2 (99% vs. 91% and 4% vs. 15%) and group 1 (99% vs. 92% and 4% vs. 17%), respectively, mainly because of a significant lower rate of beam-hardening artifacts (3 cases in group 3 vs. 22 and 27 in groups 2 and 3, respectively). In group 3, visual analog scale, HR at the end of imaging, and number of patients with premature heart beats during the scan were significantly lower than in the other groups.
  
  
  CONCLUSIONS
  Iodixanol-320 provides better image quality of coronary stents, allowing higher MDCT-CA evaluability, than iomeprol-400.
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy; Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy. Electronic address: daniele.andreini@ccfm.it.
authors.forename: Daniele
authors.initials: D
authors.lastname: Andreini
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Pontone
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy.
authors.forename: Saima
authors.initials: S
authors.lastname: Mushtaq
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy; Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy.
authors.forename: Antonio L
authors.initials: AL
authors.lastname: Bartorelli
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Conte
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy.
authors.forename: Erika
authors.initials: E
authors.lastname: Bertella
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Baggiano
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Annoni
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Formenti
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Ballerini
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy; Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy.
authors.forename: Piergiuseppe
authors.initials: P
authors.lastname: Agostoni
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy; Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Fiorentini
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Pepi
mesh_terms: D000368:Aged; D001807:Blood Vessel Prosthesis; D003287:Contrast Media / Q000008:administration & dosage / Q000737:chemistry; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000601:surgery*; D004305:Dose-Response Relationship, Drug; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D007479:Iopamidol / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000737:chemistry; D008297:Male; D009994:Osmolar Concentration; D011474:Prosthesis Design; D011829:Radiation Dosage; D011856:Radiographic Image Enhancement / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015607:Stents; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D014283:Triiodobenzoic Acids / Q000008:administration & dosage / Q000737:chemistry
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; C057937:iomeprol; C044834:iodixanol; D007479:Iopamidol
keywords: Coronary stent; Iso-osmolar low-iodine concentration contrast medium; Multidetector computed tomography coronary angiography