The evolution and investigation of native coronary arteries in patients after coronary stent implantation: a study by 320-detector CT angiography

Abstract

To study the role of 320-detector coronary computed tomography angiography (CTA) in assessing native coronary arteries in patients treated with coronary stents. 123 patients with coronary stenting received both CTA and conventional coronary angiography (CCA) within 1 day. The clinical parameters, coronary calcium scoring, CTA and CCA were analyzed to determine the prevalence of significant stenosis of native coronary arteries (SSNCA), the predictive value of CTA and the factors correlating with SSNCA and newly developed SSNCA after stenting (NDSSNCAS), with CCA as the standard of reference, using both vessel-based analysis (VBA) and patient-based analysis (PBA). Both the source and the reconstructed images were analyzed by CTA. All native coronary arteries were interpretable independent of cardiac motion. CTA showed a sensitivity/specificity of 93.5%/97.3% and 92.5%/92.5% in diagnosing SSNCA in VBA and PBA, respectively. The significant factors related to SSNCA were higher calcium scores (P = 0.003), a higher serum glucose level (P = 0.048), a greater number of vessels without previous stent placement (P = 0.003) and fewer stents implanted within the vessels (P = 0.003). The risk factors showed no significant correlation from PBA on SSNCA or from NDSSNCAS on either VBA or PBA. CTA demonstrates excellent correlation with CCA. The prevalence of SSNCA is significantly correlated with the presence of higher calcium scores in the arteries, a higher serum glucose level, a greater number of vessels without previous stent placement and fewer stents implanted within the vessels; PBA on SSNCA and NDSSNCAS on both VBA and PBA showed no significance.

Comparison of the Left Main Coronary Bifurcating Angle among Patients with Normal, Non-significantly and Significantly Stenosed Left Coronary Arteries

“…Three-dimensional quantitative coronary angiography may help to resolve this problem, but the availability is limited. Third, the 40 normal subjects in group III did not undergo CCA for confirmation; however, this could be compensated by the fact that the coronary CTA has a negative predictive rate of nearly 99% 19 . Fourth, since we believed that the hemodynamic effect of a widening LCBA might have an influence beyond the bifurcating region, we did not limit the study to patients with plaques and stenosis occurring only in the bifurcating region.…”

“…The 320-detector CTAs were performed under prospectively ECG-triggered axial acquisition according to previous published criteria 19 . If a patient’s heart rate was ≦65 bpm, then a one-heartbeat acquisition with half-scan reconstruction was performed at the mid-diastolic phase (65–85%).…”

“…All group I and II patients had CCA within 90 days (for subjects who underwent 64-detector CTA) or within 4 days (for subjects who underwent 320-detector CTA). As with the coronary CTA, the CCA was also performed according to a previously published method 19 . Aspirin (300 mg) and clopidogrel (300 mg) were given orally before angiography.…”

RETRACTED: Diagnostic accuracy of dual-source and 320-row computed tomography angiography in detecting coronary in-stent restenosis: a systematic review and meta-analysis

“…Volumetric scanning decreases patient radiation exposure through eliminating helical oversampling and furthermore reduces stair-step artifacts, observed in helical or step-and-shoot scanning techniques. In addition, the reduced scan time shortens the time of breath-hold and lowers the amount of artifacts (8,21). Therefore, DSCTA and 320-row CTA are increasingly used to detect coronary artery disease (CAD) as well as CISR evaluation.…”

“…With the rapid advancements of spatial and temporal resolution, dual-source computed tomography angiography (DSCTA) and 320-row CTA have been proven capable of obtaining high-quality images of the coronary arteries and ensuring adequate quality even with faster CTA scanning and patients' heartbeat speeds, which have increased the diagnostic accuracy of CISR and have improved wider application of DSCTA and 320-row CTA in coronary artery stent imaging. In addition, DSCTA and 320-row CTA are non-invasive methods that can be performed on outpatient basis and without any ICA-related complications to detect CISR (7,8). However, the clinical utility of DSCTA and 320row CTA to identify CISR remains questionable; this is partly because different diagnostic accuracy of the two methods has been reported (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25).…”