| Assessment of in-stent restenosis using 64-MDCT: analysis of the CORE-64 Multicenter International Trial. | |
| | |
MedLine Citation:
|
PMID: 20028909 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: Evaluations of stents by MDCT from studies performed at single centers have yielded variable results with a high proportion of unassessable stents. The purpose of this study was to evaluate the accuracy of 64-MDCT angiography (MDCTA) in identifying in-stent restenosis in a multicenter trial. MATERIALS AND METHODS: The Coronary Evaluation Using Multidetector Spiral Computed Tomography Angiography Using 64 Detectors (CORE-64) Multicenter Trial and Registry evaluated the accuracy of 64-MDCTA in assessing 405 patients referred for coronary angiography. A total of 75 stents in 52 patients were assessed: 48 of 75 stents (64%) in 36 of 52 patients (69%) could be evaluated. The prevalence of in-stent restenosis by quantitative coronary angiography (QCA) in this subgroup was 23% (17/75). Eighty percent of the stents were <or=3.0 mm in diameter. RESULTS: The overall sensitivity, specificity, positive predictive value, and negative predictive value to detect 50% in-stent stenosis visually using MDCT compared with QCA was 33.3%, 91.7%, 57.1%, and 80.5%, respectively, with an overall accuracy of 77.1% for the 48 assessable stents. The ability to evaluate stents on MDCTA varied by stent type: Thick-strut stents such as Bx Velocity were assessable in 50% of the cases; Cypher, 62.5% of the cases; and thinner-strut stents such as Taxus, 75% of the cases. We performed quantitative assessment of in-stent contrast attenuation in Hounsfield units and correlated that value with the quantitative percentage of stenosis by QCA. The correlation coefficient between the average attenuation decrease and >or=50% stenosis by QCA was 0.25 (p=0.073). Quantitative assessment failed to improve the accuracy of MDCT over qualitative assessment. CONCLUSION: The results of our study showed that 64-MDCT has poor ability to detect in-stent restenosis in small-diameter stents. Evaluability and negative predictive value were better in large-diameter stents. Thus, 64-MDCT may be appropriate for stent assessment in only selected patients. |
| | |
Authors:
|
Joanna J Wykrzykowska; Armin Arbab-Zadeh; Gustavo Godoy; Julie M Miller; Shezhang Lin; Andrea Vavere; Narinder Paul; Hiroyuki Niinuma; John Hoe; Jeffrey Brinker; Faisal Khosa; Sheryar Sarwar; Joao Lima; Melvin E Clouse |
Related Documents
:
|
19463329 - The "crush" technique for coronary artery bifurcation stenting: insights from micro-com... 10402289 - Dislodged stent: a simple retrieval technique. 16520179 - Inflammatory responses involving tumor necrosis factor receptor-associated factor 6 con... 12494969 - Use of intraluminal nitinol stents in the treatment of tracheal collapse in a dog. 8737219 - First clinical experience with a new flexible low profile metallic stent and delivery s... 1933639 - Balloon expandable stents for acute closure post failed coronary angioplasty: case repo... 19465519 - Cinaciguat, a soluble guanylate cyclase activator, causes potent and sustained pulmonar... 7226909 - The management of descending thoracic aortic aneurysms using heparinless femoral venoar... 6540479 - Exercise-related death in subjects with coexistent hypertrophic cardiomyopathy and coro... |
Publication Detail:
|
Type: Clinical Trial; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: AJR. American journal of roentgenology Volume: 194 ISSN: 1546-3141 ISO Abbreviation: AJR Am J Roentgenol Publication Date: 2010 Jan |
Date Detail:
|
Created Date: 2009-12-23 Completed Date: 2010-01-26 Revised Date: 2012-10-09 |
Medline Journal Info:
|
Nlm Unique ID: 7708173 Medline TA: AJR Am J Roentgenol Country: United States |
Other Details:
|
Languages: eng Pagination: 85-92 Citation Subset: AIM; IM |
Affiliation:
|
Department of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Contrast Media Coronary Angiography / methods* Coronary Stenosis / radiography, therapy* Female Graft Occlusion, Vascular / radiography* Humans Iopamidol / diagnostic use Male Middle Aged Predictive Value of Tests Registries Regression Analysis Sensitivity and Specificity Stents* Tomography, Spiral Computed / methods* |
| Grant Support | |
ID/Acronym/Agency:
|
HO1-HC95162-01/HC/NHLBI NIH HHS; P50 HL083813-05/HL/NHLBI NIH HHS; R01-AG021570-01/AG/NIA NIH HHS; R01-HL66075-01/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
|
0/Contrast Media; 62883-00-5/Iopamidol |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Pyothorax-associated lymphoma: imaging findings.
Next Document: Patient characteristics as predictors of image quality and diagnostic accuracy of MDCT compared with...