Clinical Evaluation of Coronary In‐Stent Restenosis Using Dual‐Source Computed Tomography

Lian-fa, Wang; Tao, Baohong; Huang, Meng-Xun; Liao, Bihong; Zhu, Youzhi; Zhou, Weiran; Li, Hua; Li, Dan; Lu, Biao; Zhang, B M Bang-Zhu; Chen, Zhe

doi:10.1111/echo.12932

Cited by 4 publications

(10 citation statements)

References 18 publications

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“…6 DS-CTA is a promising non-invasive method of assessing stent patency and can exclude significant ISR with high diagnostic values after vertebral artery ostium stenting. 13…”

Section: Discussionmentioning

confidence: 99%

“…[10][11][12] Furthermore, previous researches have indicated that it is difficult to acquire the image of coronary stent-related blood vessel segments due to interference induced by calcified plaques and metal stent artifacts. 13 Additionally, stent artifacts with small inner diameters cannot easily be distinguished with accuracy. However, due to its rapid acquisition speed, high spatial and temporal resolution, and powerful image post-processing abilities, DS-CTA has been proven tremendously useful for examining the cardiovascular system with stent artifacts.…”

Section: Introductionmentioning

confidence: 99%

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Exploring the value of the double source CT angiography in diagnosing in-stent restenosis in lower limb artery

et al. 2020

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Objectives This paper is aimed to explore the value of double source CT angiography (DS-CTA) for diagnosing in-stent restenosis in lower limb artery. Methods From January 2016 to October 2018, all patients with stent in lower limb artery in our hospital were investigated by both DS-CTA and digital subtraction angiography. We measured the minimum lumen diameter and the diameter of the proximal normal vessels under each stent placement. The in-stent restenosis is defined as restenosis when the lumen area decreased by more than 50%. Digital subtraction angiography was performed within 1 week after DS-CT scan. Relationship between DS-CTA and digital subtraction angiography for diagnosing in-stent restenosis in lower limb artery was analyzed. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of DS-CTA for diagnosis of in-stent restenosis were analyzed with digital subtraction angiography as the reference standard. A total of 68 stents were placed in 51 patients. Among these patients, 27 cases were diagnosed as in-stent restenosis, presenting as endovascular contrast agent bias or crescent filling defect with the lumen area reducing over 50%, 6 cases of which had no significant in-stent restenosis by digital subtraction angiography analysis. Furthermore, 12 cases were occlusion, in which there was no high density contrast agent in stents; the remaining 41 stents were unobstructed and the contrast agent was filled well, 8 cases of which had significant in-stent restenosis by digital subtraction angiography analysis. In addition, four stents were deformed or distorted. Statistical analysis demonstrated the concentrations of DS-CTA and digital subtraction angiography in diagnosing in-stent restenosis for lower limb artery were closely related, and the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of DS-CTA were 72.4%, 84.6%, 77.8%, 80.5%, and 79.4%, respectively. Conclusion DS-CTA has a potential reliability for diagnosis of in-stent restenosis in lower limb artery, which may be further improved to be used for clinical interventional treatment of vascular diseases.

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“…6 DS-CTA is a promising non-invasive method of assessing stent patency and can exclude significant ISR with high diagnostic values after vertebral artery ostium stenting. 13…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Exploring the value of the double source CT angiography in diagnosing in-stent restenosis in lower limb artery

et al. 2020

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“…After screening titles and/or abstracts, 3387 articles were excluded and remaining 135 articles were chosen for further inspecting. Through full-text review, 12 articles involving 13 studies, [8][9][10][11][12][13][14][15][16][17][18][19] with a total of 894 patients and 1384 assessable stents were finally included in the current meta-analysis.…”

Section: Data Analyses and Synthesesmentioning

confidence: 99%

“…This is partly due to the wide range of sensitivity (between 69% and 100%) and specificity (between 76% and 96%). [8][9][10][11][12][13][14][15][16][17][18][19] Thus, this study aimed at performing a meta-analysis, based on the currently available published articles, of the diagnostic accuracy of DSCTA in detecting CISR compared with ICA, to provide an objective evidence-based data for clinical and imaging diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of dual‐source computed tomography angiography for the detection of coronary in‐stent restenosis: A systematic review and meta‐analysis

Liu

et al. 2018

Echocardiography

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We sought to perform a meta-analysis to comprehensively evaluate the diagnostic accuracy of dual-source computed tomography angiography (DSCTA) in detecting coronary in-stent restenosis (CISR) when compared to invasive coronary angiography. The stent-based research studies in which DSCTA was used as diagnostic tool for CISR, as recent as of October 2017, from several reputed scientific libraries (PubMed, Embase, Scopus, The Cochrane Library, and Web of Science) were evaluated. Study inclusion, data extraction, and risk bias assessment were conducted by two researchers independently. Pooled sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under summary receiver operator characteristics (SROC) curve (AUC) were calculated to assess the diagnostic value. In addition, heterogeneity and subgroup analysis were also carried out. A total of 13 studies with a total of 894 patients and 1384 assessable stents were included. The pooled results of DSCTA diagnosing CISR were as follows: SEN 0.92 (95% confidence interval [CI] 0.87-0.96), SPE 0.91 (95% CI 0.87-0.94), PLR 9.83 (95% CI 6.93-13.94), NLR 0.09 (95% CI 0.05-0.15), DOR 114.73 (95% CI 64.12-205.28), and AUC 0.97 (95% CI 0.95-0.98), respectively. The subgroup analysis result suggested that DSTCA performed significantly better in CISR detection when the stent diameter was ≥3 mm compared with the stent diameter <3 mm: (0.98 [0.97-0.99] vs 0.82 [0.79-0.86]) with P < .05. This study revealed that DSCTA has excellent diagnostic performance for detecting CISR and may serve as an alternative for further patient evaluation with CISR, especially for stent diameter ≥3 mm.

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“…9,10 The advent of new techniques is likely to reach smaller stents. 11 It remains a puzzle as to why CTA is singled out by the US. It does have the potential to reduce diagnostic invasive angiography volume 12 which would generate economic concerns for clinical practices and it does shunt that work for many centers, out of cardiology and into radiology departments.…”

Section: Slant Toward Invasive Coronary Angiographymentioning

confidence: 99%

The unsaid word

Christian

2017

Journal of Nuclear Cardiology

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Clinical Evaluation of Coronary In‐Stent Restenosis Using Dual‐Source Computed Tomography

Abstract: Stent inner diameter is a key factor influencing the imaging of the stent lumen. DSCT demonstrated a higher negative predictive value in ISR assessment, suggesting that it could replace CAG for assessing the patency of stents with a larger inner diameter (≥3 mm).

Cited by 4 publications

References 18 publications

Exploring the value of the double source CT angiography in diagnosing in-stent restenosis in lower limb artery

Exploring the value of the double source CT angiography in diagnosing in-stent restenosis in lower limb artery

Diagnostic accuracy of dual‐source computed tomography angiography for the detection of coronary in‐stent restenosis: A systematic review and meta‐analysis

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