Purpose
1.
Coronary disease is increasingly treated by percutaneous coronary angioplasty.
Invasive coronary angiography with or without IVUS is the gold standard for detection of in-stent restenosis (ISR).
But,
both coronary angiography and IVUS have limitations because of their invasiveness and association with potential risks of morbidity and mortality.
2.
A noninvasive approach to evaluating these patients may be offered by 64-MDCT.
But,
there were a few studies that dealt with the diagnostic accuracy of ISR detection of 64-MDCT compared with IVUS which considered an accurate...
Methods and Materials
Patients
Between March 2008 and November 2008,
39 patients scheduled for follow up coronary angiography with IVUS and 64-MDCT after coronary stent implantation were consecutively investigated.
Inclusion criteria for this study is male or non-pregnant female ≥18 years of age and those who had coronary artery disease treated by percutaneous coronary intervention with stent implantation and planned follow-up coronary angiography to evaluate ISR.
We excluded patient with the followings: renal insufficiency (serum creatinine ≥ 2.0 mg/dL),
contraindication to beta-blockers (3rd-degree AV block,
decreased left ventricular...
Results
We evaluate 43 stents in 39 patients.
Baseline clinical characteristics of the study population are summarized in Figure 1.The average time interval between stent implantation and MDCT coronary angiography was is 708.87 ± 388.67; MDCT coronary angiography and follow up conventional coronary angiography was 20.72 ± 7.78.
The site of stent implantation was: right coronary artery in 10(23.3%),
left anterior descending coronary artery in 25(58.1%),
left circumflex coronary artery in 7(16.3%),
and ramus intermedius artery in 1(2.3%).
Sensitivity,
specificity,
positive predictive value,
and negative predictive...
Conclusion
An optimal cutoff value of minimal lumen cross sectional area of coronary stents on 64 MDCT is 6.2mm2.
Coronary stents with 64-MDCT may be valuable as a noninvasive method of detecting significant ISR.
References
1.
Fischman DL,
Leon MB,
Baim DS et al.
A randomized comparison of coronary-stent placement and balloon angioplasty in the treatment of coronary artery disease.
Stent Restenosis Study Investigators.
N Engl J Med.
1994;331(8):496-501.
2.
Serruys PW,
de Jaegere P,
Kiemeneij F et al.
A comparison of balloon-expandable-stent implantation with balloon angioplasty in patients with coronary artery disease.
Benestent Study Group.
N Engl J Med.
1994;331(8):489-95.
3.
Dibra A,
Kastrati A,
Mehilli J et al.
Paclitaxel-eluting or sirolimus-eluting stents to prevent restenosis in diabetic patients....
Personal Information
J.
Choi,
W.
Kwon.
Department of Radiology,
Wonju Christian Hospital,
Wonju College of Medicine,
Yonsei University,
Wonju,
South Korea.
mail to
[email protected]