Title: Role of Multi-detector Row (320) CT Coronary Angiography in Assessment of Coronary Stents in Comparison with Coronary Angiography
Authors: Amr Asem Ali Omran, Ashraf Mohammed Enite, Emam Mohammed Abd-Elaziz
DOI: https://dx.doi.org/10.18535/jmscr/v9i10.02
Abstract
Background: Coronary artery disease (CAD) is the leading cause of morbidity and mortality in industrialized society. To treat patients with obstructive atherosclerosis, percutaneous coronary intervention with stent implantation is routinely performed, which considerably reduces the rate of restenosis as compared with balloon angioplasty.
Aim of the Work: to evaluate multi-detector CT angiography as a less invasive technique in the assessment of the coronary stent patency and compared with the conventional angiography findings (as a gold standard technique).
Patients and Methods: This study included 50 patients with prior coronary stent deployment, 32 of them (64%) underwent conventional angiography as a gold standard for evaluation of the patency of the coronary stents. The indications of conventional angiography were unstable angina in 10 cases out of the 32 cases (31.25 %), while the rest were performed to assess stent patency after suspected instent re-stenosis or atypical chest pain in 22 cases out of 32 (68.75 %).
Results: In this study CT angiography compared to the conventional angiography as a gold standard technique gave us a sensitivity of 92.3%, a specificity of about 100 %, an accuracy of about 95.6 %, PPV of 100% and NPV of 90.5 % as regarding patent stent taking into consideration that 2 stents were non evaluable due to narrow stent caliber (2.5mm.) but proved patent by conventional angiography, but these results will much improved if the non evaluable stents removed from statistical analysis.
Conclusion: Our study recommends usage of latest multi-detector row CT scanners as a first-line tool for the noninvasive evaluation of patients with suspected instent restenosis especially with stents diameter ≥ 3mm. and helps to identify factors that influence the assess ability of coronary artery stents by 320 MDCT scanners, namely, stent type and diameter.
Keywords: Multi-detector Row (320) - CT Coronary Angiography - Coronary Stents.
References
- de Graaf FR, Schuijf JD, van Velzen JE, et al. Diagnostic accuracy of 320-row multidetector computed tomography coronary angiography in the non-invasively assess in-stent restenosis. Investigative Radiology. 2010; 45(6): 1908-15.
- Dewey M, Teige F, Schnapauff D, Laule M, Borges AC, Wernecke KD, et al. Noninvasive detection of coronary artery stenoses with multislice computed tomography or magnetic resonance imaging. Ann Intern Med 2006; 145:407–15
- Andreini D, Pontone G, Bartorelli AL, Trabattoni D, Mushtaq S, Bertella E, Annoni A, Formenti A, Cortinovis S, Montorsi P, Veglia F. Comparison of feasibility and diagnostic accuracy of 64-slice multidetector computed tomographic coronary angiography versus invasive coronary angiography versus intravascular ultrasound for evaluation of in-stent restenosis. The American journal of cardiology. 2009; 103(10):1349-58.
- Dawoud MA, Alarabawy RA, Alla TM, Mubarak AA. Evaluation of coronary stents using multidetector CT. The Egyptian Journal of Radiology and Nuclear Medicine. 2016; 47(3):793-801.
- Carbone I, Francone M, Algeri E, et al. Non-invasive evaluation of coronary artery stent patency with retrospectively ECG-gated 64-slice CT angiography. Eur Radiol 2008; 18: 234-243.