This Article Full Text 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 Storto, M. L. Articles by Bonomo, L. Search for Related Content PubMed PubMed Citation Articles by Storto, M. L. Articles by Bonomo, L. Related Collections Restenosis Catheter-based coronary interventions: stents CT and MRI

(Circulation. 2002;105:2005.)
© 2002 American Heart Association, Inc.

Images in Cardiovascular Medicine

Multislice Spiral Computed Tomography for In-Stent Restenosis

Maria Luigia Storto, MD; Riccardo Marano, MD; Nicola Maddestra, MD; Marcello Caputo, MD; Marco Zimarino, MD; Lorenzo Bonomo, MD

From the Department of Clinical Sciences and Bioimaging, University of Chieti, Italy.

Correspondence to Maria Luigia Storto, MD, Dept of Clinical Sciences and Bioimaging, Section of Radiology, SS.Annunziata Hospital, University of Chieti, Via dei Vestini, 66100 Chieti, Italy. E-mail ml.storto@radiol.unich.it

A 72-year-old man was admitted for recurrent episodes of chest pain 3 months after stent deployment in the left anterior descending (LAD) artery. The patient underwent a computerized tomographic (CT) examination of the thorax with a multislice spiral CT scanner (MSCT) (Somatom Volume Zoom, Siemens). A dynamic study was performed with acquisition of 20 scans at the level of the LAD distal to the stented segment during injection of 20 mL of nonionic contrast medium (370 mgI/mL); the resultant time-density curves were suggestive of high-grade stenosis (Figure 1A). Thereafter, a cardiac CT scan with retrospective electrocardiographic gating and injection of 110 mL of contrast medium was performed. Axial images were reconstructed with an absolute delay of 400 ms before the next R-wave. Three-dimensional volume-rendered images were also obtained; 2 overlapping stents were identified in the mid LAD without lumen reduction at the margins (Figures 2A and 2B). Coronary angiography documented a subocclusive in-stent restenosis, with TIMI (thrombolysis in myocardial infarction) grade 2 flow in the LAD. Rotational atherectomy followed by adjunctive angioplasty was performed, without residual stenosis. Before discharge, the patient underwent a second MSCT scan, which showed good opacification of LAD distal to the stented segment, whereas the repeated time-density curves were consistent with the absence of stenosis in LAD (Figure 1B). Although an accurate evaluation of in-stent lumen remains problematic, MSCT is a promising noninvasive technique that may provide useful information on stent localization, functional relevance of in-stent restenosis, and the status . . . [Full Text of this Article]

This article has been cited by other articles:

				G. Muhlenbruch, A. H. Mahnken, M. Das, R. Blindt, C. Hohl, J. E. Wildberger, R. W. Gunther, H. P. Kuhl, and R. Koos Evaluation of Aortocoronary Bypass Stents with Cardiac MDCT Compared with Conventional Catheter Angiography Am. J. Roentgenol., February 1, 2007; 188(2): 361 - 369. [Abstract] [Full Text] [PDF]

				T. Gaspar, D. A. Halon, B. S. Lewis, S. Adawi, J. E. Schliamser, R. Rubinshtein, M. Y. Flugelman, and N. Peled Diagnosis of Coronary In-Stent Restenosis With Multidetector Row Spiral Computed Tomography J. Am. Coll. Cardiol., October 18, 2005; 46(8): 1573 - 1579. [Abstract] [Full Text] [PDF]