Multi-detector-row CT angiography in the assessment of coronary in-stent restenosis: a systematic review

Sun, Zhonghua; Davidson, Roger; Lin, Chad

doi:10.1016/j.clinimag.2009.08.004

Cited by 10 publications

(13 citation statements)

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“…However, mean prevalence of in-stent restenosis was low with 18% leading to a bias. No significant difference was found between 16-and 64-detector row CT [18].…”

Section: Discussionmentioning

confidence: 66%

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Coronary artery stent imaging with 128-slice dual-source CT using high-pitch spiral acquisition in a cardiac phantom: comparison with the sequential and low-pitch spiral mode

et al. 2010

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“…However, mean prevalence of in-stent restenosis was low with 18% leading to a bias. No significant difference was found between 16-and 64-detector row CT [18].…”

Section: Discussionmentioning

confidence: 66%

“…A recent meta-analysis [18] pooling 15 in vivo studies (utilising both 16-and 64-slice CT) revealed estimates of the sensitivity and specificity for detection of coronary instent restenosis of 85% and 97%, respectively. However, mean prevalence of in-stent restenosis was low with 18% leading to a bias.…”

Section: Discussionmentioning

confidence: 99%

Coronary artery stent imaging with 128-slice dual-source CT using high-pitch spiral acquisition in a cardiac phantom: comparison with the sequential and low-pitch spiral mode

et al. 2010

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“…21 These were small studies, and there are no studies or reviews comparing CTA with DSA, the golden standard, in stented carotid arteries. A 2007 review compared CTA with DSA in stented coronary arteries and found a sensitivity and specificity of 85% (95% CI 78%–90%) and 97% (95% CI: 95%–98%) for 16 - to 64-detector row CT scanners, 22 which are similar when compared with CTA and DSA in unstented carotid arteries. There was no difference between the different types of CT scanners.…”

Section: Discussionmentioning

confidence: 99%

Optimal cut-off criteria for duplex ultrasound compared with computed tomography angiography for the diagnosis of restenosis in stented carotid arteries in the international carotid stenting study

Bosch

Hendrikse

Davagnanam

et al. 2016

European Stroke Journal

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Introduction: Previous studies that reported duplex-ultrasound cut-off criteria, based on blood velocity parameters, for the degree of stenosis in a stented carotid artery were either retrospective, or the reference test was carried out only when a patient was suspected of having restenosis at duplex ultrasound, which is likely to have resulted in verification bias. We performed a prospective study of diagnostic accuracy to find new blood velocity cut-offs in duplex ultrasound for in-stent restenosis. Patients and methods: Stented patients within the international carotid stenting study were eligible. Patients had a carotid computed tomography angiography in addition to routine duplex ultrasound performed at a yearly follow-up. Duplex-ultrasound bloodflow velocity parameters were compared to the degree of stenosis on computed tomography angiography. The results were analysed using receiver-operating-characteristic curves. Results: We included 103 patients in this study. On computed tomography angiography, 30 (29.1%) patients had a 30%-49% in-stent restenosis, 21 (20.4%) patients had 50%-69% in-stent restenosis and 5 (4.9%) patients a 70% in-stent restenosis. The cut-off value 50% stenosis was a peak systolic velocity of 125 cm/s (sensitivity: 63% (95% CI: 41-79), specificity: 83% (95% CI: 72-90)). Discussion: This study provides a level 2b evidence for new cut-off values for in-stent restenosis. Unfortunately, we could not say anything about severe stenosis because of the low number of severe stenosis after one year. Conclusions: The 125 cm/s cut-off value on duplex ultrasound is lower than found in previous studies and equal to unstented arteries. Duplex-ultrasound measurements made in stented carotid arteries should not be corrected for the presence of a stent when determining the degree of stenosis.

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“…This creates the appearance of a dark line down the middle of the intra-stent lumen. The "halo effect" may impair proper visualization of the intra-stent lumen (Reproduced with permission from BioMed Central (unrestricted use) from André et al [32]) findings were also demonstrated in the meta-analyses by Sun et al [34,35] Sun also points out that in addition to stent size, stent material, strut size, blooming and filter type, several other factors affect the accuracy of CCTA stent imaging, including higher heart rates (motion artifact) and severe calcification of the coronary arteries [34]. Akin to the dictum that larger stents are more reliably evaluated clinically by CCTA, Roura et al [36] confirmed the accuracy of left main coronary artery (LM) stent imaging by CCTA as compared to intravascular ultrasound.…”

Section: Evaluation Of Coronary Stentsmentioning

confidence: 91%

Cardiac CT Angiography Manual

Pelberg

2015

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Multi-detector-row CT angiography in the assessment of coronary in-stent restenosis: a systematic review

Cited by 10 publications

References 0 publications

Coronary artery stent imaging with 128-slice dual-source CT using high-pitch spiral acquisition in a cardiac phantom: comparison with the sequential and low-pitch spiral mode

Coronary artery stent imaging with 128-slice dual-source CT using high-pitch spiral acquisition in a cardiac phantom: comparison with the sequential and low-pitch spiral mode

Optimal cut-off criteria for duplex ultrasound compared with computed tomography angiography for the diagnosis of restenosis in stented carotid arteries in the international carotid stenting study

Cardiac CT Angiography Manual

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