OBJECTIVES: The aim of this study was to evaluate the diagnostic accuracy of dual-source computed tomography coronary angiography (CTCA) compared to coronary angiography (CAG) and intravascular ultrasound (IVUS) for detection and quantification of in-stent restenosis after left main (LM) coronary artery stenting. MATERIALS AND METHODS: Fifty-one patients with percutaneous coronary intervention of the LM were prospectively evaluated. Thirty-four of them underwent 56 complete follow-up examinations (CTCA, CAG, and IVUS as gold standard examination) that focused on detection and quantification of restenosis. RESULTS: Sensitivity, specificity, and positive and negative predictive values were 100%, 94%, 50%, and 100% for CAG, respectively, and 100%, 74%, 18%, and 100% for CTCA, respectively. There was a correlation between the minimal luminal areas (MLA) measured by CTCA and IVUS (r = 0.63; P<.01). A Bland-Altman analysis showed that the MLA measured by CTCA was underestimated (mean difference, 2.14 ± 2.24 mm²). CONCLUSION: Dual-source CTCA has a high negative predictive value and might be considered a less invasive alternative to CAG for exclusion of LM in-stent restenosis. However, there was only a moderate correlation between the MLA measurements by IVUS and CTCA in the stented LMs. Moreover, the present results suggest a systematic underestimation of MLAs measured by CTCA. Therefore, finding of any restenosis according to CTCA should be re-evaluated by CAG or, better, by subsequent IVUS.
OBJECTIVES: The aim of this study was to evaluate the diagnostic accuracy of dual-source computed tomography coronary angiography (CTCA) compared to coronary angiography (CAG) and intravascular ultrasound (IVUS) for detection and quantification of in-stent restenosis after left main (LM) coronary artery stenting. MATERIALS AND METHODS: Fifty-one patients with percutaneous coronary intervention of the LM were prospectively evaluated. Thirty-four of them underwent 56 complete follow-up examinations (CTCA, CAG, and IVUS as gold standard examination) that focused on detection and quantification of restenosis. RESULTS: Sensitivity, specificity, and positive and negative predictive values were 100%, 94%, 50%, and 100% for CAG, respectively, and 100%, 74%, 18%, and 100% for CTCA, respectively. There was a correlation between the minimal luminal areas (MLA) measured by CTCA and IVUS (r = 0.63; P<.01). A Bland-Altman analysis showed that the MLA measured by CTCA was underestimated (mean difference, 2.14 ± 2.24 mm²). CONCLUSION: Dual-source CTCA has a high negative predictive value and might be considered a less invasive alternative to CAG for exclusion of LM in-stent restenosis. However, there was only a moderate correlation between the MLA measurements by IVUS and CTCA in the stented LMs. Moreover, the present results suggest a systematic underestimation of MLAs measured by CTCA. Therefore, finding of any restenosis according to CTCA should be re-evaluated by CAG or, better, by subsequent IVUS.
Authors: Parastou Eslami; Eline M J Hartman; Mazen Albaghadai; Julia Karady; Zexi Jin; Vikas Thondapu; Nicholas V Cefalo; Michael T Lu; Ahmet Coskun; Peter H Stone; Alison Marsden; Udo Hoffmann; Jolanda J Wentzel Journal: Ann Biomed Eng Date: 2020-10-16 Impact factor: 3.934
Authors: Young Jin Kim; Hwan Seok Yong; Sung Mok Kim; Jeong A Kim; Dong Hyun Yang; Yoo Jin Hong Journal: Korean J Radiol Date: 2015-02-27 Impact factor: 3.500
Authors: Pengfei Zhang; Song Chen; Yang Li; Qiuhong Du; Lijuan Wang; Yingxian Sun; Yaming Li Journal: Exp Ther Med Date: 2016-11-04 Impact factor: 2.447