In Vivo Assessment of Coronary Stents With 64-Row Multidetector Computed Tomography

Papini, Giacomo Davide Edoardo; Casolo, F; Leo, Giovanni Di; Briganti, Silvia; Fantoni, Cecilia; Medda, Massimo; Inglese, Luigi; Ambroggi, L. De; Sardanelli, Francesco

doi:10.1097/rct.0b013e3181ddbbc0

Cited by 7 publications

(7 citation statements)

References 24 publications

(15 reference statements)

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“…Four-and 16-slice CT were of limited value in the assessment CISR owing to frequent incidence of stent-related artifacts and cardiac motion, which significantly decreased the accuracy and lead up to 36% stents to be considered as inaccessible in 16-slice CT (5,32). With the application of 64-slice CT, some of these limitations have been partially overcome due to the improvement of temporal and spatial resolutions (33,34). A previous meta-analysis performed by Carrabba et al (6) reported that 64-slice CT can reach weighted SEN of 86% and SPE of 93% in the detection of CISR compared to ICA.…”

Section: Discussionmentioning

confidence: 99%

“…First of all, a major problem concerning assessment of stents defined as beamhardening artifacts could result in artificial luminal narrowing, decreased intraluminal attenuation values, and make stents appear larger than they actually are (36). Second, the presence of metal within the coronary stent struts can lead to high-density artifacts (blooming artifacts), which can potentially decrease the accuracy in interpreting ISR and therefore can became one of the important causes of a false-positive result or diagnosis (33,36). Furthermore, our study reported that stents with smaller diameters (<3 mm) might have had a negative influence on CISR diagnosis compared to bigger stent diameters, mainly because smaller stent diameters are more difficult to visualize in lumen in MSCT (25,32).…”

Section: R E T R a C T E Dmentioning

confidence: 99%

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RETRACTED: Diagnostic accuracy of dual-source and 320-row computed tomography angiography in detecting coronary in-stent restenosis: a systematic review and meta-analysis

Liu

Wang

et al. 2018

Acta Radiol

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Background Dual-source and 320-row computed tomography angiography (CTA) are increasingly used in diagnosing coronary in-stent restenosis (CISR). Purpose We sought to perform this meta-analysis to evaluate the diagnostic accuracy of dual-source computed tomography angiography (DSCTA) and 320-row CTA in detecting CISR when compared to invasive coronary angiography. Material and Methods Five scientific databases (PubMed, Embase, Scopus, The Cochrane Library, and Web of Science) were searched for research studies in which DSCTA and/or 320-row CTA were used as diagnostic tools for CISR, as recently as October 2017. Study inclusion, data extraction, systematic review, pooled meta-analysis, and subgroup analysis were conducted by two researchers independently. Results Thirteen studies with 1384 assessable stents on DSCTA and five studies including 622 assessable stents on 320-row CTA were finally included. The sensitivity, specificity, and area under the curve (AUC) of DSCTA in diagnosing CISR were 0.92 (0.87-0.96), 0.91 (0.87-0.94), and 0.97 (0.95-0.98), respectively, and they were 0.91 (0.82-0.96), 0.95 (0.88-0.98), and 0.96 (0.94-0.97) for 320-row CTA. Subgroup analysis result suggested that DSTCA performed significantly better in CISR detection when the stent diameter was ≥ 3 mm compared to stent diameter < 3 mm: 0.98 (0.97-0.99) vs. 0.82 (0.79-0.86) with P < 0.05. Conclusion Our meta-analysis indicated both DSCTA and 320-row CTA had high diagnostic accuracy in detecting CISR and may serve as alternatives for further patient evaluation with CISR, especially for stent diameters ≥ 3 mm.

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Section: Discussionmentioning

confidence: 99%

Section: R E T R a C T E Dmentioning

confidence: 99%

RETRACTED: Diagnostic accuracy of dual-source and 320-row computed tomography angiography in detecting coronary in-stent restenosis: a systematic review and meta-analysis

Liu

Wang

et al. 2018

Acta Radiol

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“…First of all, a major problem concerning assessment of stents defined as blooming (beam hardening) artifacts could result in artificial luminal narrowing, decreased intraluminal attenuation values, and make stents appear larger than they actually are . Second, the presence of metal within the coronary stent struts can lead to high‐density artifacts, which can potentially decrease the accuracy in interpreting CISR and therefore became one of the important causes of false‐positive result or diagnosis . Third, our study reported that stents with smaller diameters (<3 mm) might have had a negative influence on CISR diagnosis compared with bigger stents diameters, mainly because smaller stent diameters are more difficult to be visualized in lumen in DSCTA .…”

Section: Discussionmentioning

confidence: 84%

“…Four‐ and 16‐slice CTA were of limited value in assessing CISR owing to frequent incidence of stent‐related artifacts and cardiac motion, which significantly decrease the accuracy and lead up to 36% stents to be considered as inaccessible in 16‐slice CT . With the application of 64‐slice CT, some of these limitations have been partially overcome due to the improvement of temporal and spatial resolutions . A previous meta‐analysis performed by Carrabba et al reported that 64‐slice CT can reach weighted SEN of 86% and SPE of 93% in the detection of CISR as compared to ICA.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of dual‐source computed tomography angiography for the detection of coronary in‐stent restenosis: A systematic review and meta‐analysis

Liu

et al. 2018

Echocardiography

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We sought to perform a meta-analysis to comprehensively evaluate the diagnostic accuracy of dual-source computed tomography angiography (DSCTA) in detecting coronary in-stent restenosis (CISR) when compared to invasive coronary angiography. The stent-based research studies in which DSCTA was used as diagnostic tool for CISR, as recent as of October 2017, from several reputed scientific libraries (PubMed, Embase, Scopus, The Cochrane Library, and Web of Science) were evaluated. Study inclusion, data extraction, and risk bias assessment were conducted by two researchers independently. Pooled sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under summary receiver operator characteristics (SROC) curve (AUC) were calculated to assess the diagnostic value. In addition, heterogeneity and subgroup analysis were also carried out. A total of 13 studies with a total of 894 patients and 1384 assessable stents were included. The pooled results of DSCTA diagnosing CISR were as follows: SEN 0.92 (95% confidence interval [CI] 0.87-0.96), SPE 0.91 (95% CI 0.87-0.94), PLR 9.83 (95% CI 6.93-13.94), NLR 0.09 (95% CI 0.05-0.15), DOR 114.73 (95% CI 64.12-205.28), and AUC 0.97 (95% CI 0.95-0.98), respectively. The subgroup analysis result suggested that DSTCA performed significantly better in CISR detection when the stent diameter was ≥3 mm compared with the stent diameter <3 mm: (0.98 [0.97-0.99] vs 0.82 [0.79-0.86]) with P < .05. This study revealed that DSCTA has excellent diagnostic performance for detecting CISR and may serve as an alternative for further patient evaluation with CISR, especially for stent diameter ≥3 mm.

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“…Better temporal and spatial resolution permit a negative predictive value (NPV; 90–100%) [ 54 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 ]. In comparison to earlier systems, the new generation MSCT overcomes the restrictions that were caused due to low resolution [ 67 , 68 ].…”

Section: In-stent Restenosis Monitoringmentioning

confidence: 99%

Health Care Monitoring and Treatment for Coronary Artery Diseases: Challenges and Issues

Alghrairi

Sulaiman

Mutashar

2020

Sensors

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In-stent restenosis concerning the coronary artery refers to the blood clotting-caused re-narrowing of the blocked section of the artery, which is opened using a stent. The failure rate for stents is in the range of 10% to 15%, where they do not remain open, thereby leading to about 40% of the patients with stent implantations requiring repeat procedure within one year, despite increased risk factors and the administration of expensive medicines. Hence, today stent restenosis is a significant cause of deaths globally. Monitoring and treatment matter a lot when it comes to early diagnosis and treatment. A review of the present stent monitoring technology as well as the practical treatment for addressing stent restenosis was conducted. The problems and challenges associated with current stent monitoring technology were illustrated, along with its typical applications. Brief suggestions were given and the progress of stent implants was discussed. It was revealed that prime requisites are needed to achieve good quality implanted stent devices in terms of their size, reliability, etc. This review would positively prompt researchers to augment their efforts towards the expansion of healthcare systems. Lastly, the challenges and concerns associated with nurturing a healthcare system were deliberated with meaningful evaluations.

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In Vivo Assessment of Coronary Stents With 64-Row Multidetector Computed Tomography

Abstract: Metal artifacts cause overlooking of nonsignificant stenosis.

Cited by 7 publications

References 24 publications

RETRACTED: Diagnostic accuracy of dual-source and 320-row computed tomography angiography in detecting coronary in-stent restenosis: a systematic review and meta-analysis

RETRACTED: Diagnostic accuracy of dual-source and 320-row computed tomography angiography in detecting coronary in-stent restenosis: a systematic review and meta-analysis

Diagnostic accuracy of dual‐source computed tomography angiography for the detection of coronary in‐stent restenosis: A systematic review and meta‐analysis

Health Care Monitoring and Treatment for Coronary Artery Diseases: Challenges and Issues

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