Coronary angiography and dual-source computed tomography are complementary methods in diagnosis of significant stenosis of the right coronary artery originating from the left aortic sinus

Veselka, Josef; Zemánek, David; Duchoňová, Radka; Blaško, Peter; Adla, Theodor; Tesař, David; Neuwirth, J

doi:10.2478/s11536-007-0053-z

Cited by 2 publications

(2 citation statements)

References 13 publications

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“…Subacute stent thrombosis occurs in approximately 0.5-1% of implanted stents [5,6], and one of the reasons considered is high residual platelet activity [7,8]. There are many factors involving the platelet reactivity [9][10][11] and one must be very cautious in interpreting the results. Despite mentioned limitation this complication has a frequent catastrophic course with a high mortality rate [1], and thus it represents a significant risk for patients treated with stent implantation.…”

Section: Discussionmentioning

confidence: 99%

High-residual platelet activity despite dual antiplatelet treatment associated with subacute stent thrombosis

et al. 2009

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AbstractHigh-residual platelet activity despite the dual antiplatelet treatment with aspirin and clopidogrel is associated with major adverse cardiac events, including stent thrombosis. Acute and subacute stent thrombosis is rare, but presents itself with serious complications including high mortality and morbidity rates. Light transmittance aggregometry with specific agonists — arachidonic acid and 5-adenosin diphosphate — is still considered a standard for the assessment of platelet reactivity, besides novel methods like vasodilator-stimulated phosphoprotein phosphorylation. In our case study, we report the coincidence of high-residual platelet activity with subacute stent thrombosis despite the recommended doses of antiplatelet agents — aspirin and clopidogrel. Stent thrombosis was treated by aspiration thrombectomy, and antiplatelet treatment was modified by increasing the dose of aspirin and substituting clopidogrel with a firstgeneration thienopyridin — ticlopidin. The effect of the treatment was documented by reaching the optimal inhibition of platelet reactivity. In the 6- and 12-month follow-up, the patient presented no ischemic events.

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Section: Discussionmentioning

confidence: 99%

High-residual platelet activity despite dual antiplatelet treatment associated with subacute stent thrombosis

et al. 2009

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“…All CT examinations were performed on a dual-source CT scanner (Somatom Definition, Siemens Medical Solutions, Forchheim, Germany) with 70 to 100 ml of iodixanol (Iomeron, 400 mg/ml, Altana-Bracco, Germany) followed by 40 ml of saline solution [ 13 ]. Two doses of sublingual isosorbide dinitrate spray were used at the start of the examination.…”

Section: Methodsmentioning

confidence: 99%

Dual-source computed tomography angiography and intravascular ultrasound assessment of restenosis in patients after coronary stenting for bifurcation left main stenosis: a pilot study

Veselka¹,

Čadová²,

Adla³

et al. 2012

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IntroductionThe aim of this prospective study was to evaluate the diagnostic accuracy of dual-source computed tomography coronary angiography (CTCA) compared to intravascular ultrasound (IVUS) for the detection of restenosis in patients who underwent coronary stenting for bifurcation left main (LM) stenosis.Material and methodsTwenty-four patients underwent percutaneous intervention of the LM and were subsequently examined (median 9.2 months after procedure) using IVUS and CTCA for the detection of restenosis.ResultsSignificant restenosis was detected according to IVUS examination in 6 patients (25%) and 8 segments (13%). Based on segment analysis, sensitivity, specificity, positive and negative predictive values of CTCA for the detection of restenosis were 89%, 68%, 32%, 97%, respectively. There was moderate to good correlation between the minimal luminal area (MLA), measured by CTCA and IVUS for LM, the left anterior descending artery (LAD) and the left circumflex artery (LCx) (r=0.64, p<0.01; r=0.49, p=0.03; r=0.76, p<0.01, respectively). A Bland-Altman analysis showed that the MLAs measured by CTCA were underestimated in all segments (mean difference 1.67 ±2.2 mm2 for LM; 2.0 ±2.0 mm2 for LAD; 1.79 ±1.79 mm2 for LCx). An ROC analysis of the MLAs derived by CTCA for detecting significant stenosis was performed. The area under the curve for all analysed segments was 0.73.ConclusionsThe present study demonstrates that in patients after LM bifurcation stenting CTCA performs well in the exclusion of in-segment restenosis. However, due to the low positive predictive value of CTCA, the finding of any restenosis should be confirmed by invasive examination.

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Coronary angiography and dual-source computed tomography are complementary methods in diagnosis of significant stenosis of the right coronary artery originating from the left aortic sinus

Cited by 2 publications

References 13 publications

High-residual platelet activity despite dual antiplatelet treatment associated with subacute stent thrombosis

High-residual platelet activity despite dual antiplatelet treatment associated with subacute stent thrombosis

Dual-source computed tomography angiography and intravascular ultrasound assessment of restenosis in patients after coronary stenting for bifurcation left main stenosis: a pilot study

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