Carsten Rist MD, Abstract Co-Author: Nothing to Disclose

Franz von Ziegler MD, Abstract Co-Author: Nothing to Disclose

Konstantin Nikolaou MD, Abstract Co-Author: Nothing to Disclose

Miles A. Kirchin PhD, Abstract Co-Author: Employee, Bracco Group

Bernd Juergen Wintersperger MD, Abstract Co-Author: Nothing to Disclose

Thorsten Ralph Christopher Johnson MD, Presenter: Nothing to Disclose

Andreas Knez MD, Abstract Co-Author: Nothing to Disclose

Maximilian Ferdinand Reiser MD, Abstract Co-Author: Nothing to Disclose

Christoph Becker MD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

Restenosis remains a major limitation of coronary catheter-based stent placement. Therefore, a reliable non-invasive diagnostic method for the evaluation of stented coronary arteries would be highly desirable. Our aim was to evaluate the diagnostic accuracy of high-resolution 64-slice Computed Tomography (64DCT) for the assessment of the lumen of coronary artery stents.

Twenty-five patients underwent 64DCT of the coronary arteries and quantitative X-ray coronary angiography (QCA) after coronary artery stent placement. 64DCT coronary angiography was performed with the following parameters: spatial resolution = 0.4x0.4x0.4 mm; temporal resolution = 83-165 ms; contrast agent = 80 ml at a flow rate of 5 ml/s; retrospective ECG-gating. The 64DCT scans were evaluated for image quality and for the presence of significant in-stent and peri-stent (proximal and distal) stenoses. Determinations were made of the sensitivity, specificity, diagnostic accuracy and positive and negative predictive values (PPV and NPV) of 64DCT for the detection or exclusion of stenoses.

A total of 46 stents were evaluated of which 45 (98%) were of diagnostic image quality. Significant in-stent restenosis or occlusion was detected on QCA in 8/45 cases (≥50% stenosis = 6; occlusion = 2). The sensitivity, specificity, accuracy, PPV and NPV of 64DCT for the detection of significant in-stent disease was 75%, 92%, 89%, 67% and 94%. Both occluded coronary artery stents were correctly identified. The sensitivity, specificity and accuracy values of 64DCT for the detection of significant proximal stent stenoses were 75%, 95% and 93%, respectively, while the values for distal stent stenoses were 67%, 85% and 84%, respectively.

The improved spatial and temporal resolution 64DCT is beneficial for the assessment of stent occlusion and peri-stent disease although grading of in-stent stenosis remains difficult.

64DCT is beneficial for the assessment of stent occlusion and peri-stent disease although grading of in-stent stenosis remains difficult.

Rist, C, von Ziegler, F, Nikolaou, K, Kirchin, M, Wintersperger, B, Johnson, T, Knez, A, Reiser, M, Becker, C, et al, , Assessment of Coronary Artery Stent Patency and Restenosis Using 64-Slice Computed Tomography.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4433398.html