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Coronary stent assessability by 64 slice multi-detector computed tomography

Authors

  • Tej Sheth MD,

    Corresponding author
    1. Cardiac MR-PET-CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
    2. Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
    • Assistant Professor of Medicine, McMaster University, 237 Barton Street E, 5th Floor, Hamilton, ON, Canada L8L 2X2
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  • Jonathan D. Dodd MD,

    1. Cardiac MR-PET-CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
    2. Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
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  • Udo Hoffmann MD,

    1. Cardiac MR-PET-CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
    2. Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
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  • Suhny Abbara MD,

    1. Cardiac MR-PET-CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
    2. Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
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  • Aloke Finn MD,

    1. Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
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  • Herman K. Gold MD,

    1. Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
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  • Thomas J. Brady MD,

    1. Cardiac MR-PET-CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
    2. Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
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  • Ricardo C. Cury MD

    1. Cardiac MR-PET-CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
    2. Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
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Abstract

Background: We evaluated the assessability of contemporary stent platforms by 64-slice multi-detector computed tomography (MDCT). Methods. Patients undergoing coronary stenting were included in a prospective protocol of MDCT imaging within 48 hr of stent implantation. MDCT data were acquired using a “Sensation 64” MDCT scanner (Siemens Medical Solutions, Forchheim, Germany). Stent assessability was assessed by two independent blinded observers and disagreement was resolved by a third observer. Assessability was defined at visualization of the in-stent lumen without influence of partial volume effects, beam hardening, motion, calcification, or contrast to noise limitations. Results: Fifty four stents (Cypher n = 25, Vision/Minivision n = 19, Taxus Express n = 8, Liberte n = 1, Driver n = 1) in 44 patients were included in the study. The two independent observers classified 30 of 54 stents (56%) as assessable. Interobserver reproducibility was good with κ = 0.66. Stent size was the most important determinant of assessability. Consistently assessable stents were 3.0 mm or larger (85%), whereas those under 3 mm were mostly nonassessable (26%).Conclusions: Contemporary stent designs evaluated on a 64-slice MDCT scanner showed artifact free assessability only in larger stents. Increase in spatial resolution of MDCT scanners or modifications in stent design will be necessary to noninvasive evaluate stents <3 mm in diameter, where in-stent restenosis is more frequent. © 2007 Wiley-Liss, Inc.

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