Abstract 13277: Noninavasive Assessment of In-Stent Restenosis by High Definition Computed Tomography Coronary Angiography with New Gemstone Detector
Purpose: Noninvasive assessment of in-stent restenosis (ISR) by computed tomography coronary angiography has been challenging. Recently high definition computed tomography (HDCT) coronary angiography with new gemstone detector has been developed, which has high spatial resolution, so it may lead to significant improvement of accuracy to diagnose ISR. The purpose of this study is to assess ISR using HDCT coronary angiography.
Methods: We enrolled consecutive 40 patients with previous coronary stent implantation who were received HDCT coronary angiography for clinical indications. HDCT coronary angiography studies were performed using a HDCT (GE Discovery CT750 HD). Image quality for the evaluation of ISR was assessed using 5-point grading scale: IQ score (1=excellent, 5=non-assessable). Significant ISR was defined as >50% luminal narrowing in the stent lumen or the presence of significant stent edge stenosis.
Results: 31 male and 9 female (age 69±8.9 years) with 68 stents (1.7±0.8 stents/patient) were evaluated. There were 17 bare-metal and 51 drug-eluting stents with an average diameter 3.3±0.8mm. Image quality was good on average (score 2.3±1.5). A total of 8 stents (12%) were of nondiagnostic image quality (IQ score 4 or 5) (feasibility 88%). 8 stents were diagnosed as ISR by HDCT which is also diagnosed as ISR by invasive coronary angiography (100%). There was no false negative example of HDCT in 12 patients with 19 stents who were received invasive coronary angiography within one month after HDCT. There was 28 stents, including 25 silorimus-eluting stents, with diameters of 2.5mm, and 86% was assessable. Feasibility in stents with diameters of 2.5mm has no significant difference with that of >2.5mm (p=0.59).
Conclusions: HDCT coronary angiography with new gemstone detector allows accurate noninvasive assessment of significant ISR. Noninvasive assessment of ISR using HDCT could be attractive and feasible alternative.
- © 2010 by American Heart Association, Inc.