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. 2006 Jan;92(1):58-61.
doi: 10.1136/hrt.2004.056010. Epub 2005 Apr 21.

Assessment of coronary artery stents by 16 slice computed tomography

M Gilard  1 , J C Cornily, P Y Pennec, G Le Gal, M Nonent, J Mansourati, J J Blanc, J Boschat
Affiliations

Assessment of coronary artery stents by 16 slice computed tomography

M Gilard et al. Heart. 2006 Jan.

Abstract

Objective: To analyse coronary stents with multislice spiral computed tomography (MSCT) in comparison with coronary angiography.

Patients and methods: 310 patients referred for conventional coronary angiography underwent MSCT on the next day (16 x 0.75 mm cross section, 420 ms rotation, 110 ml contrast agent intravenously at 4 ml/s). Two independent blinded reviewers analysed the MSCT.

Results: 143 patients had previous stenting (232 stents) and 190 (82%) of the 232 stents were detected. Intrastent lumen was interpretable in 126 (64%) of the detected stents. Lumen interpretability depended on stent diameter: for stent diameter > 3 mm, 81% of lumens were interpretable, as against 51% with < or = 3 mm stent diameter (p < 0.001). Restenosis detection likewise depended on stent diameter: with small stents (< or = 3 mm), sensitivity and specificity of MSCT were 54% and 100%, respectively; positive and negative predictive values were 100% and 94%. For stents with > 3 mm diameter, corresponding values were 86%, 100%, 100%, and 99%.

Conclusion: 16 slice MSCT allows analysis of in-stent lumen in about half of all stented angioplasties. It performs better when stent diameter is more than 3 mm and may offer a non-invasive alternative to conventional coronary angiography for monitoring stented coronary arteries. Technical progress may improve interpretability and hence increase the yield of MSCT in this application.

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