European Heart Journal Advance Access originally published online on October 11, 2006
European Heart Journal 2006 27(21):2567-2572; doi:10.1093/eurheartj/ehl303
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Assessment of coronary artery stent restenosis by 64-slice multi-detector computed tomography
1 Department of Internal Medicine 2 (Cardiology), University of Erlangen, Ulmenweg 18, 91054 Erlangen, Germany
2 Institute for Diagnostic Radiology, University of Erlangen, Erlangen, Germany
Received 2 May 2006; revised 7 September 2006; accepted 21 September 2006; online publish-ahead-of-print 11 October 2006.
* Corresponding author. Tel: +49 9131 8535000; fax: +49 9131 8535303. E-mail address: stephan.achenbach{at}med2.med.uni-erlangen.de
Aims We investigated the feasibility of assessing coronary artery stent restenosis using a new generation 64-slice multi-detector computed tomography-scanner (MDCT) in comparison to conventional quantitative angiography.
Methods and results MDCT was performed in 64 consecutive patients (mean age 58±10 years) with previously implanted coronary artery stents (102 stented lesions: mean stent diameter 3.17±0.38 mm). Each stent was classified as ‘evaluable’ or ‘unevaluable’, and in evaluable stents, the presence of in-stent restenosis (diameter reduction >50%) was determined visually. Results were verified against invasive, quantitative coronary angiography. Fifty-nine stented lesions (58%) were classified as evaluable in MDCT. The mean diameter of evaluable stents was 3.28±0.40 mm, whereas the mean diameter of non-evaluable stents was 3.03±0.31 mm (P=0.0002). Overall, six of 12 in-stent restenoses were correctly detected by MDCT [50% sensitivity (confidence interval 22–77%)] and in 51 of 90 lesions, in-stent restenosis was correctly ruled out [57% specificity (46–67%)]. In evaluable stents, six of seven in-stent restenoses were correctly detected, and the absence of in-stent stenosis was correctly identified in 51 of 52 cases [sensitivity 86% (42–99%) and specificity 98% (88–100%)].
Conclusion Stent type and diameter influence evaluability concerning in-stent restenosis by MDCT. The rate of assessable stents is low, but in evaluable stents, accuracy for detection of in-stent restenosis can be high.
Key Words: Computed tomography • Stent • Restenosis • Angiography
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