BACKGROUND: Multislice spiral computed tomography (MSCT) has evolved as a new promising method for non-invasive visualization of the coronary arteries and detection of native coronary artery stenosis. We determined the value of MSCT to non-invasively detect significant in-stent restenosis after coronary artery stenting. METHODS: Twenty patients (age 56.3+/-8.6 years) were investigated by MSCT (4x1 mm cross-sections, 500 ms tube rotation, table feed 1.5 mm/rotation, intravenous contrast agent, retrospectively ECG-gated image reconstruction) at a mean interval of 9.6+/-4.2 months after coronary stent implantation. Results were compared with conventional quantitative coronary angiography (QCA). A total number of 32 stents were studied, four different stent types were evaluated. RESULTS: QCA showed in-stent restenosis >50% diameter stenosis in five (16%) stents. Using MSCT it was impossible in all stents, irrespective of stent type or diameter, to directly visualize the stent lumen due to partial volume effects and beam hardening. MSCT allowed the visualization of the coronary vessel proximal and distal to the stent. This allowed confirmation of stent patency in 18/18 cases and correct identification of total stent occlusion in two patients. CONCLUSIONS: MSCT allows no direct visualization of coronary in-stent restenosis, but it correctly differentiates between stent patency and stent occlusion. The reasons are mainly partial volume effects and beam hardening, which are induced by the stent material.
BACKGROUND: Multislice spiral computed tomography (MSCT) has evolved as a new promising method for non-invasive visualization of the coronary arteries and detection of native coronary artery stenosis. We determined the value of MSCT to non-invasively detect significant in-stent restenosis after coronary artery stenting. METHODS: Twenty patients (age 56.3+/-8.6 years) were investigated by MSCT (4x1 mm cross-sections, 500 ms tube rotation, table feed 1.5 mm/rotation, intravenous contrast agent, retrospectively ECG-gated image reconstruction) at a mean interval of 9.6+/-4.2 months after coronary stent implantation. Results were compared with conventional quantitative coronary angiography (QCA). A total number of 32 stents were studied, four different stent types were evaluated. RESULTS: QCA showed in-stent restenosis >50% diameter stenosis in five (16%) stents. Using MSCT it was impossible in all stents, irrespective of stent type or diameter, to directly visualize the stent lumen due to partial volume effects and beam hardening. MSCT allowed the visualization of the coronary vessel proximal and distal to the stent. This allowed confirmation of stent patency in 18/18 cases and correct identification of total stent occlusion in two patients. CONCLUSIONS: MSCT allows no direct visualization of coronary in-stent restenosis, but it correctly differentiates between stent patency and stent occlusion. The reasons are mainly partial volume effects and beam hardening, which are induced by the stent material.
Authors: Harald Seifarth; Rainer Raupach; Stefan Schaller; Eva Maria Fallenberg; Thomas Flohr; Walter Heindel; Roman Fischbach; David Maintz Journal: Eur Radiol Date: 2005-02-12 Impact factor: 5.315
Authors: Tiziano Schepis; Pascal Koepfli; Sebastian Leschka; Lotus Desbiolles; Lars Husmann; Oliver Gaemperli; Franz R Eberli; Simon Wildermuth; Borut Marincek; Thomas F Lüscher; Hatem Alkadhi; Philipp A Kaufmann Journal: Eur Radiol Date: 2007-01-06 Impact factor: 5.315
Authors: T Schlosser; T Scheuermann; S Ulzheimer; O K Mohrs; M Kühling; P E Albrecht; T Voigtländer; J Barkhausen; A Schmermund Journal: Clin Res Cardiol Date: 2007-08-21 Impact factor: 5.460
Authors: Martin Heuschmid; Benjamin Wiesinger; Gunnar Tepe; Oliver Luz; Andreas F Kopp; Claus D Claussen; Stephan H Duda Journal: Eur Radiol Date: 2006-05-30 Impact factor: 5.315