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(Circulation. 2003;107:147.)
© 2003 American Heart Association, Inc.

Images in Cardiovascular Medicine

Coronary Artery Patency After Metallic Stent Implantation Evaluated by Multislice Computed Tomography

Nobusada Funabashi, MD; Nobuyuki Komiyama, MD; Noriyuki Yanagawa, RT; Takafumi Mayama, MD; Katsuya Yoshida, MD; Issei Komuro, MD

From the Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine (N.F., T.M., K.Y., I.K); and the Center for Cardiovascular Interventions (N.K., I.K.) and the Department of Radiology (N.Y.), Chiba University Hospital, Chiba, Japan.

Correspondence to Issei Komuro, MD, Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan. E-mail komuro-tky{at}umin.ac.jp

A56-year-old man presented to our hospital because of chest pain on effort. Conventional coronary angiography revealed high-grade stenosis in the proximal and distal portions of the left anterior descending branch (LAD). We therefore performed percutaneous transluminal coronary angioplasty with metallic stent implantation at the stenotic sites. Four months after the stent placement, ECG-gated enhanced multislice computed tomography (CT) (Light Speed Ultra, General Electric) was performed with a 1.25-mm slice thickness, helical pitch 3.25, to evaluate the coronary artery lumen for restenosis at the stent implantation sites. After intravenous injection of 100 mL of iodinated contrast material (350 mgI/mL), CT scanning was performed with retrospective ECG-gated reconstruction. After acquisition, volume data were extracted from end-diastole, and volume-rendering images were generated (M900 Zio). In the axial source image and cut-plane volume rendering image, the patency of the coronary arterial lumen of the proximal portion of the LAD surrounded by the metallic stent (arrows, Figure 1, arrows) was observed without any artifact from the metallic stent. The next day, conventional coronary angiography showed no significant luminal stenosis of the proximal (Figure 2, arrow) and distal portions of the LAD.

View larger version (79K): [in this window] [in a new window]   Figure 1. Axial source image (A) and volume rendering (VR) image (B) of the proximal portion of the LAD using end-diastolic data from enhanced multislice CT. Arrows show the stent located in the proximal portion of the LAD. A, The axial source image shows the patent coronary arterial lumen surrounded by the metallic stent (arrow). B, Cut-plane VR image from the superior left anterior view shows the vessel lumen surrounded by the metallic stent (arrow). The color curves were set to represent the vessel lumen filled with contrast material as yellow and the metallic stent as white. The metallic stent with CT numbers above those of the contrast-enhanced coronary artery lumen could be distinguished by VR, and the patency of the lumen surrounded by the metallic stent appeared to be maintained. The arrowhead in the VR image indicates the stent located in the distal portion of the LAD. Patency of the coronary artery lumen of the distal portion of the LAD could not be evaluated.

View larger version (162K): [in this window] [in a new window]   Figure 2. Left anterior oblique and cranial projection of conventional coronary angiogram showing no significant luminal stenosis of the proximal portion of the LAD where the metallic stent was located (arrow). LCx indicates left circumflex branch.

Footnotes

The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.

Circulation encourages readers to submit cardiovascular images to the Circulation Editorial Office, St Luke’s Episcopal Hospital/Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.

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This Article Extract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Funabashi, N. Articles by Komuro, I. Search for Related Content PubMed PubMed Citation Articles by Funabashi, N. Articles by Komuro, I. Related Collections CT and MRI