BACKGROUND: The number of patients with obstructive coronary artery disease, who undergo coronary angioplasty with implantation of stents, is ever increasing. As an alternative to catheter-based angiography, ECG-gated multi-slice spiral computed tomography (MSCT) allows noninvasive imaging of the coronary arteries. However, coronary stents have been notoriously difficult to assess by CT. METHODS AND RESULTS: In vitro experiments were performed, using varying detector collimations, contrast concentrations, stent positions and stent diameters, to evaluate the feasibility and image characteristics of stents. The stent-related high-density artifacts expand the apparent size of the stent struts. This blooming effect is a fairly constant phenomenon, and therefore relatively less evident in larger-diameter stents. The in vivo images show the same artifacts, but assessment is further complicated by motion, lower contrast-to-noise, and vessel wall calcifications. CONCLUSIONS: The clinical value of CT after percutaneous coronary intervention currently remains largely limited to the detection of stent occlusion, and the progression of coronary artery disease in the remaining nonstented segments. Subtle in-stent abnormalities cannot be reliably imaged. Some relief will be offered by improvements in scanner technology, but the use of less radiopaque stent material would be more effective.
BACKGROUND: The number of patients with obstructive coronary artery disease, who undergo coronary angioplasty with implantation of stents, is ever increasing. As an alternative to catheter-based angiography, ECG-gated multi-slice spiral computed tomography (MSCT) allows noninvasive imaging of the coronary arteries. However, coronary stents have been notoriously difficult to assess by CT. METHODS AND RESULTS: In vitro experiments were performed, using varying detector collimations, contrast concentrations, stent positions and stent diameters, to evaluate the feasibility and image characteristics of stents. The stent-related high-density artifacts expand the apparent size of the stent struts. This blooming effect is a fairly constant phenomenon, and therefore relatively less evident in larger-diameter stents. The in vivo images show the same artifacts, but assessment is further complicated by motion, lower contrast-to-noise, and vessel wall calcifications. CONCLUSIONS: The clinical value of CT after percutaneous coronary intervention currently remains largely limited to the detection of stent occlusion, and the progression of coronary artery disease in the remaining nonstented segments. Subtle in-stent abnormalities cannot be reliably imaged. Some relief will be offered by improvements in scanner technology, but the use of less radiopaque stent material would be more effective.
Authors: Thomas J Oxley; Nicholas L Opie; Sam E John; Gil S Rind; Stephen M Ronayne; Tracey L Wheeler; Jack W Judy; Alan J McDonald; Anthony Dornom; Timothy J H Lovell; Christopher Steward; David J Garrett; Bradford A Moffat; Elaine H Lui; Nawaf Yassi; Bruce C V Campbell; Yan T Wong; Kate E Fox; Ewan S Nurse; Iwan E Bennett; Sébastien H Bauquier; Kishan A Liyanage; Nicole R van der Nagel; Piero Perucca; Arman Ahnood; Katherine P Gill; Bernard Yan; Leonid Churilov; Christopher R French; Patricia M Desmond; Malcolm K Horne; Lynette Kiers; Steven Prawer; Stephen M Davis; Anthony N Burkitt; Peter J Mitchell; David B Grayden; Clive N May; Terence J O'Brien Journal: Nat Biotechnol Date: 2016-02-08 Impact factor: 54.908
Authors: P G C Begemann; U van Stevendaal; R Manzke; A Stork; F Weiss; C Nolte-Ernsting; M Grass; G Adam Journal: Eur Radiol Date: 2005-01-21 Impact factor: 5.315
Authors: V Chabbert; D Carrie; M Bennaceur; E Maupas; V Lauwers; M Mhem; T Lhermusier; M Elbaz; F Joffre; H Rousseau; J Puel Journal: Eur Radiol Date: 2006-11-18 Impact factor: 5.315
Authors: A S Turk; H A Rowley; D B Niemann; D Fiorella; B Aagaard-Kienitz; K Pulfer; C M Strother Journal: AJNR Am J Neuroradiol Date: 2007-09-24 Impact factor: 3.825