Clinical usefulness of the 16-slice computed tomography Coronary angiography for evaluation of early phase intracoronary stent patency

Abstract

Coronary artery stenting is currently treatment of choice for management of coronary artery disease. Stent restenosis is the most important problem during follow up. Conventional coronary angiography is the gold standart for assessment of intracoronary stent patency. It is an invasive method and even though rare, has some significant risks. For this reason, noninvasive imaging methods are necessary to evaluate stent patency. Noninvasive methods such as the exercise test, myocardial perfusion scintigraphy and stress echocardiography could not reach enough diagnostic accuracy. Multislice computed tomography (MSCT) has been under investigation for stent restenosis detection. Aim of this study is to investigate usefulness of the 16-slice CT for evaluation of stent patency in patients with suspicion of stent restenosis. Thirty six patients were included in the study and 16-slice CT and conventional coronary angiographies were performed in all patients. The results of 16-slice CT and conventional coronary angiography were compared. Sufficient or good quality imaging with 16-slice CT angiography was obtained in 69% of all patients. Sixteen-slice CT angiography detected 42/49 (86%) stents and gave the correct localization for all of the detected stents. Stent lumen could be assessed in 30 (61%) stents and according to the results of luminal assessment, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of 16-slice MSCT were calculated as 33%, 95%, 75%, 77% and 77%, respectively. According to these results, the diagnostic performance of 16-slice CT angiography for detection of stent restenosis was relatively low. However, the assessment of relatively small number of stents because of insufficient heart rate control did not allow reliable and precise evaluation. Our results showed that diagnostic capacity of 16-slice CT angiography for detection of coronary stent restenosis is limited. © 2013 OMU.