Diagnosis of Coronary In-Stent Restenosis With Multidetector Row Spiral Computed Tomography

Gaspar, Tamar; Halon, David A.; Lewis, Basil S.; Adawi, Salim; Schliamser, Jorge E.; Rubinshtein, Ronen; Flugelman, Moshe Y.; Peled, Nathan

doi:10.1016/j.jacc.2005.07.049

Cited by 151 publications

(74 citation statements)

References 16 publications

(6 reference statements)

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“…Unfortunately, only 72% of all stented vessels were assessable in study populations. Recently, Gaspar et al (48) attempted to assess the efficacy of 40-slice MDCT in similar evaluations of post-PCI restenosis. This study found that 96% of stented vessels could be assessed by 40-slice MDCT.…”

Section: Assessment Of In-stent Restenosis Using Mdctmentioning

confidence: 99%

Transitioning from 16-slice to 64-slice multidetector computed tomography for the assessment of coronary artery disease: Are we really making progress?

Khan

Rawal

Eisenberg

2009

Canadian Journal of Cardiology

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Section: Assessment Of In-stent Restenosis Using Mdctmentioning

confidence: 99%

Transitioning from 16-slice to 64-slice multidetector computed tomography for the assessment of coronary artery disease: Are we really making progress?

Khan

Rawal

Eisenberg

2009

Canadian Journal of Cardiology

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“…For example, thick-strut stents (>140 μm) are reported to have low sensitivity on MDCT as compared with thin-strut stents (<140 μm). [20][21][22][23] Another report suggested that tantalum, gold or gold-coated stents, and covered stent grafts had reduced visualization of the lumen compared with stainless steel or cobalt stents. 24 The present study included both 2.25-mm and 2.5-mm stents (a total of 105/33.2%), classified as small stents, but Cypher stent was used at a high rate (62.3%), these being made of stainless steel, but with a strut thickness of 140 μm which provides severe artifacts on evaluation of the in-stent lumen.…”

Section: Discussionmentioning

confidence: 99%

Assessment of In-Stent Restenosis Using High-Definition Computed Tomography With a New Gemstone Detector

Tsuda

Ishii

Ichimiya

et al. 2015

Circ J

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1542TSUDA T et al. Circulation JournalOfficial Journal of the Japanese Circulation Society http://www. j-circ.or.jpMoreover, stents with diameter <3 mm are reported to have lower assessability than those ≥3 mm. 16 As an alternative method, stress tests could be used for non-invasive detection of ISR, but unfortunately the diagnostic accuracy is not so high. Although invasive coronary angiography (ICA) is the most reliable method for assessing ISR, there are disadvantages due to the possible serious complications during the procedure, and high cost. Thus, CTCA is the preferred modality to detect ISR in patients undergoing previous coronary stent implantation because it can visualize the in-stent lumen, non-invasively. Discovery CT 750HD (GE Healthcare Technologies, WI, USA) is a high-definition CT (HDCT) machine with a new gemstone detector (GE Gemstone TM detector). Gemstone is a complex rare earth-based oxide that has a chemically replicated garnet crystal structure, and has a primary speed of only 30 ns (100-fold faster than existing detectors) and low afterglow (4 times lower), which is a key contributor to fast kVP switching acquisition through its scintillator and data ercutaneous coronary intervention with stent implantation reduces restenosis of culprit lesions compared with plain-old balloon angioplasty alone. 1,2 Moreover, drug-eluting stents (DES) have remarkably improved results by preventing excessive neo-intimal hyperplasia of coronary arteries, 3,4 so that they are now widely used for small vessels, long lesions, and those with bifurcations, for example. 5,6 But even in the DES era, lesion complexity or patient comorbidities are related to restenosis. 7 Recently, computed tomography coronary angiography (CTCA) has become established in the non-invasive assessment of coronary stents. Multi-slice computed tomography (MSCT) or multi-detector computed tomography (MDCT) with 64-slice technology has improved the spatial resolution with a sensitivity of 82-95% and a specificity of 82-98% for de novo lesions of the coronary artery. 8, 9 Reports so far have indicated that MSCT or MDCT have a sensitivity of 90-95%, and a specificity of 73-93% for detecting in-stent restenosis (ISR). 10-15 It is sometimes difficult, however, to assess in-stent lumens due to stent strut artifacts. Background: Until now, there have been few reports on the accuracy of in-stent restenosis (ISR) detection using high-definition computed tomography (HDCT). The purpose of this study was to assess ISR using HDCT with a new gemstone detector and to examine the diagnostic accuracy compared with invasive coronary angiography.

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“…The stent struts create a blooming artefact which makes the stent struts much larger, thereby obscuring part of the in-stent lumen. Stent evaluation is usually limited to the assessment of stent patency which is quite reliable, but in particular, the smaller sized stents (≤ 3mm in diameter) do not permit evaluation of the presence of neo-intimal hyperplasia or in-stent restenosis (41)(42)(43)(44)(45) .…”

Section: Ct-coronary Angiography For Assessment Of Coronary Stentsmentioning

confidence: 99%

Computed Tomography of the Coronary Arteries

Feyter

Weustink

Alberghina

et al. 2017

SAHJ

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MSCT Coronary Angiography is a fast developing non-invasive diagnostic technique that can detect a coronary stenosis. The detection of a coronary stenosis is hampered by limited image quality and by motion artefacts and extensive calcifi cations. However, MSCT-coronary angiography is highly reliable to rule out coronary stenosis. The role of MSCT-coronary angiography in the diagnostic work-up of coronary artery disease needs further research. ABSTRACTFIGURE 1: The X-ray tube and the detectors rotate in an opposing position of the gantry around the patient. A collimated X-ray beam is passed through the patient and the attenuated X-ray beam is collected on the detectors while the patient on the couch is continuously advanced through the gantry. 64 parallel detector rows acquire the data in a very short scan time.

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Diagnosis of Coronary In-Stent Restenosis With Multidetector Row Spiral Computed Tomography

Abstract: In-stent restenosis can be diagnosed with moderate sensitivity using a new generation 40-slice MDCT scanner. The high NPV implies a significant role for MDCT in excluding ISR.

Cited by 151 publications

References 16 publications

Transitioning from 16-slice to 64-slice multidetector computed tomography for the assessment of coronary artery disease: Are we really making progress?

Transitioning from 16-slice to 64-slice multidetector computed tomography for the assessment of coronary artery disease: Are we really making progress?

Assessment of In-Stent Restenosis Using High-Definition Computed Tomography With a New Gemstone Detector

Computed Tomography of the Coronary Arteries

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