Non-invasive computed tomography angiography in the assessment of coronary stent patency: An Australian experience

K. H. Soon, N. Cox, I. Chaitowitz, J. B. Selvanayagam, O. Farouque, L. MacGregor, K. W. Bell, Y. L. Lim

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: This study aimed to evaluate the feasibility and accuracy of 16-slice computed tomography (CT) in the assessment of coronary stent patency. CT coronary angiography (CA) has a high degree of accuracy in the assessment of coronary artery disease compared with invasive selective CA. However, its accuracy in the evaluation of stent patency is not well investigated. Methods: We conducted a retrospective observational study of paired CT coronary angiography (CT-CA) and invasive fluoroscopic coronary angiography (FCA) in 37 patients with 47 coronary stents. CT-CA was carried out with an electrocardiogram-gated 16-slice CT (LightSpeed-16, General Electric (GE), WI, USA). Two CT reporters, blinded to the FCA findings, assessed CT images for stent patency. A cardiologist blinded to CT findings reported FCA. FCA was regarded as the reference standard. Results: A CT-CA could assess 45 of 47 coronary stents (96%). Non-assessable stents on CT-CA were due to motion artefacts and stent-blooming effects. Of those 45 assessable stents, CT-CA correctly identified five out of seven stents with binary in-stent restenosis (ISR) and 37 of 38 stents without binary ISR. The sensitivity and specificity of 16-slice CT in the evaluation of coronary stents for binary ISR were 71% (95% confidence interval (CI) (29%, 96%)) and 97% (95%CI (86%, 100%)), respectively, exclusive of non-assessable stents. The positive and negative predictive values of 16-slice CT were 83% (95%CI (36%, 100%)) and 95% (95%CI (83%, 99%)), respectively. Conclusion: Sixteen-slice CT has a low sensitivity, but very a high specificity when compared with FCA in the evaluation of coronary stents for ISR.

LanguageEnglish
Pages360-364
Number of pages5
JournalInternal Medicine Journal
Volume37
Issue number6
DOIs
Publication statusPublished - 1 Jun 2007

Keywords

  • In-stent restenosis
  • Percutaneous coronary intervention

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Soon, K. H. ; Cox, N. ; Chaitowitz, I. ; Selvanayagam, J. B. ; Farouque, O. ; MacGregor, L. ; Bell, K. W. ; Lim, Y. L. / Non-invasive computed tomography angiography in the assessment of coronary stent patency : An Australian experience. In: Internal Medicine Journal. 2007 ; Vol. 37, No. 6. pp. 360-364.
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abstract = "Background: This study aimed to evaluate the feasibility and accuracy of 16-slice computed tomography (CT) in the assessment of coronary stent patency. CT coronary angiography (CA) has a high degree of accuracy in the assessment of coronary artery disease compared with invasive selective CA. However, its accuracy in the evaluation of stent patency is not well investigated. Methods: We conducted a retrospective observational study of paired CT coronary angiography (CT-CA) and invasive fluoroscopic coronary angiography (FCA) in 37 patients with 47 coronary stents. CT-CA was carried out with an electrocardiogram-gated 16-slice CT (LightSpeed-16, General Electric (GE), WI, USA). Two CT reporters, blinded to the FCA findings, assessed CT images for stent patency. A cardiologist blinded to CT findings reported FCA. FCA was regarded as the reference standard. Results: A CT-CA could assess 45 of 47 coronary stents (96{\%}). Non-assessable stents on CT-CA were due to motion artefacts and stent-blooming effects. Of those 45 assessable stents, CT-CA correctly identified five out of seven stents with binary in-stent restenosis (ISR) and 37 of 38 stents without binary ISR. The sensitivity and specificity of 16-slice CT in the evaluation of coronary stents for binary ISR were 71{\%} (95{\%} confidence interval (CI) (29{\%}, 96{\%})) and 97{\%} (95{\%}CI (86{\%}, 100{\%})), respectively, exclusive of non-assessable stents. The positive and negative predictive values of 16-slice CT were 83{\%} (95{\%}CI (36{\%}, 100{\%})) and 95{\%} (95{\%}CI (83{\%}, 99{\%})), respectively. Conclusion: Sixteen-slice CT has a low sensitivity, but very a high specificity when compared with FCA in the evaluation of coronary stents for ISR.",
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Non-invasive computed tomography angiography in the assessment of coronary stent patency : An Australian experience. / Soon, K. H.; Cox, N.; Chaitowitz, I.; Selvanayagam, J. B.; Farouque, O.; MacGregor, L.; Bell, K. W.; Lim, Y. L.

In: Internal Medicine Journal, Vol. 37, No. 6, 01.06.2007, p. 360-364.

Research output: Contribution to journalArticle

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AU - Soon, K. H.

AU - Cox, N.

AU - Chaitowitz, I.

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KW - Percutaneous coronary intervention

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