Tao Dai1, Jiang-Rong Wang2, Peng-Fei Hu3. 1. Department of Cardiology, Yuhuangding Hospital, Qingdao University, Yantai, Shandong, 264000, China. 2. Department of Cardiology, Qianfoshan Hospital, ShanDong University, Ji'nan, Shandong, 250014, China. 3. Department of Cardiology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang, Hangzhou, 310005, China. pengfei_hu@163.com.
Abstract
OBJECTIVES: To evaluate the performance of computed tomography angiography (CTA) ≥64 slices for detecting coronary in-stent restenosis (ISR) and determine the influence of separate characteristics on diagnostic accuracy. METHODS: We searched the PubMed, EMBASE and Cochrane databases for studies of CTA ≥64 slices in diagnosing ISR. We pooled data on bivariate modelling, and subgroup analysis was also performed. RESULTS: A total of 35 studies involving 4131 stents were included. The pooled positive likelihood ratio (LR+) and the negative likelihood ratio (LR-) were 14.0 and 0.10, for CTA in diagnosis-significant ISR ≥50%. LR+ and LR- were similar between CTA >64 slices versus 64 slices (both P > 0.99). LR- (0.10) was good for ruling out suspected ISR for <3-mm diameter. Time between CTA and stent implantation >6 months did not affect the ability of CTA for the high LR+ (12.3) and the LR- (0.10). Thick-strut stents ≥100 μm or bifurcation stenting demonstrated inferior accuracy, which was unfavourable for stent imaging. CONCLUSIONS: With the high LR+ and LR- of CTA, patients with ISR may be appropriate for non-invasive angiographic follow-up. However, CTA imaging seems unsuitable for patients with characteristics unfavourable for stent imaging, such as thick-strut stents or bifurcation stenting. KEY POINTS: • CTA may provide accurate information on characteristics of in-stent restenosis lesions. • Using CTA, ISR patients may be appropriate for non-invasive angiographic follow-up. • Stent diameter and the number of slices do not influence CTA. • CTA seems unsuitable for patients with thick-strut stents or bifurcation stenting.
OBJECTIVES: To evaluate the performance of computed tomography angiography (CTA) ≥64 slices for detecting coronary in-stent restenosis (ISR) and determine the influence of separate characteristics on diagnostic accuracy. METHODS: We searched the PubMed, EMBASE and Cochrane databases for studies of CTA ≥64 slices in diagnosing ISR. We pooled data on bivariate modelling, and subgroup analysis was also performed. RESULTS: A total of 35 studies involving 4131 stents were included. The pooled positive likelihood ratio (LR+) and the negative likelihood ratio (LR-) were 14.0 and 0.10, for CTA in diagnosis-significant ISR ≥50%. LR+ and LR- were similar between CTA >64 slices versus 64 slices (both P > 0.99). LR- (0.10) was good for ruling out suspected ISR for <3-mm diameter. Time between CTA and stent implantation >6 months did not affect the ability of CTA for the high LR+ (12.3) and the LR- (0.10). Thick-strut stents ≥100 μm or bifurcation stenting demonstrated inferior accuracy, which was unfavourable for stent imaging. CONCLUSIONS: With the high LR+ and LR- of CTA, patients with ISR may be appropriate for non-invasive angiographic follow-up. However, CTA imaging seems unsuitable for patients with characteristics unfavourable for stent imaging, such as thick-strut stents or bifurcation stenting. KEY POINTS: • CTA may provide accurate information on characteristics of in-stent restenosis lesions. • Using CTA, ISR patients may be appropriate for non-invasive angiographic follow-up. • Stent diameter and the number of slices do not influence CTA. • CTA seems unsuitable for patients with thick-strut stents or bifurcation stenting.
Authors: Carsten Rist; Franz von Ziegler; Konstantin Nikolaou; Miles A Kirchin; Bernd J Wintersperger; Thorsten R Johnson; Andreas Knez; Alexander W Leber; Maximilian F Reiser; Christoph R Becker Journal: Acad Radiol Date: 2006-12 Impact factor: 3.173
Authors: Sigurdis Haraldsdottir; Thorarinn Gudnason; Axel F Sigurdsson; Jonina Gudjonsdottir; Sam J Lehman; Kristjan Eyjolfsson; Sigurpall S Scheving; C Michael Gibson; Udo Hoffmann; Birna Jonsdottir; Karl Andersen Journal: Eur J Radiol Date: 2009-06-30 Impact factor: 3.528
Authors: Gianluca Pontone; Alexia Rossi; Marco Guglielmo; Marc R Dweck; Oliver Gaemperli; Koen Nieman; Francesca Pugliese; Pal Maurovich-Horvat; Alessia Gimelli; Bernard Cosyns; Stephan Achenbach Journal: Eur Heart J Cardiovasc Imaging Date: 2022-02-22 Impact factor: 6.875
Authors: Jagat Narula; Y Chandrashekhar; Amir Ahmadi; Suhny Abbara; Daniel S Berman; Ron Blankstein; Jonathon Leipsic; David Newby; Edward D Nicol; Koen Nieman; Leslee Shaw; Todd C Villines; Michelle Williams; Harvey S Hecht Journal: J Cardiovasc Comput Tomogr Date: 2020-11-20
Authors: Lucy Lu; Qi Sheng Phua; Stephen Bacchi; Rudy Goh; Aashray K Gupta; Joshua G Kovoor; Christopher D Ovenden; Minh-Son To Journal: JAMA Netw Open Date: 2022-08-01