Non-invasive computed tomography angiography in the assessment of coronary stent patency: An Australian experience

K. H. Soon, N. Cox, I. Chaitowitz, J. B. Selvanayagam, O. Farouque, L. MacGregor, K. W. Bell, Y. L. Lim

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: This study aimed to evaluate the feasibility and accuracy of 16-slice computed tomography (CT) in the assessment of coronary stent patency. CT coronary angiography (CA) has a high degree of accuracy in the assessment of coronary artery disease compared with invasive selective CA. However, its accuracy in the evaluation of stent patency is not well investigated. Methods: We conducted a retrospective observational study of paired CT coronary angiography (CT-CA) and invasive fluoroscopic coronary angiography (FCA) in 37 patients with 47 coronary stents. CT-CA was carried out with an electrocardiogram-gated 16-slice CT (LightSpeed-16, General Electric (GE), WI, USA). Two CT reporters, blinded to the FCA findings, assessed CT images for stent patency. A cardiologist blinded to CT findings reported FCA. FCA was regarded as the reference standard. Results: A CT-CA could assess 45 of 47 coronary stents (96%). Non-assessable stents on CT-CA were due to motion artefacts and stent-blooming effects. Of those 45 assessable stents, CT-CA correctly identified five out of seven stents with binary in-stent restenosis (ISR) and 37 of 38 stents without binary ISR. The sensitivity and specificity of 16-slice CT in the evaluation of coronary stents for binary ISR were 71% (95% confidence interval (CI) (29%, 96%)) and 97% (95%CI (86%, 100%)), respectively, exclusive of non-assessable stents. The positive and negative predictive values of 16-slice CT were 83% (95%CI (36%, 100%)) and 95% (95%CI (83%, 99%)), respectively. Conclusion: Sixteen-slice CT has a low sensitivity, but very a high specificity when compared with FCA in the evaluation of coronary stents for ISR.

Original languageEnglish (US)
Pages (from-to)360-364
Number of pages5
JournalInternal Medicine Journal
Volume37
Issue number6
DOIs
StatePublished - Jun 2007
Externally publishedYes

Fingerprint

Stents
Coronary Angiography
Tomography
Confidence Intervals
Computed Tomography Angiography
Artifacts
Observational Studies
Coronary Artery Disease
Electrocardiography
Retrospective Studies

Keywords

  • In-stent restenosis
  • Percutaneous coronary intervention

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Soon, K. H., Cox, N., Chaitowitz, I., Selvanayagam, J. B., Farouque, O., MacGregor, L., ... Lim, Y. L. (2007). Non-invasive computed tomography angiography in the assessment of coronary stent patency: An Australian experience. Internal Medicine Journal, 37(6), 360-364. https://doi.org/10.1111/j.1445-5994.2007.01363.x

Non-invasive computed tomography angiography in the assessment of coronary stent patency : An Australian experience. / Soon, K. H.; Cox, N.; Chaitowitz, I.; Selvanayagam, J. B.; Farouque, O.; MacGregor, L.; Bell, K. W.; Lim, Y. L.

In: Internal Medicine Journal, Vol. 37, No. 6, 06.2007, p. 360-364.

Research output: Contribution to journalArticle

Soon, KH, Cox, N, Chaitowitz, I, Selvanayagam, JB, Farouque, O, MacGregor, L, Bell, KW & Lim, YL 2007, 'Non-invasive computed tomography angiography in the assessment of coronary stent patency: An Australian experience', Internal Medicine Journal, vol. 37, no. 6, pp. 360-364. https://doi.org/10.1111/j.1445-5994.2007.01363.x
Soon, K. H. ; Cox, N. ; Chaitowitz, I. ; Selvanayagam, J. B. ; Farouque, O. ; MacGregor, L. ; Bell, K. W. ; Lim, Y. L. / Non-invasive computed tomography angiography in the assessment of coronary stent patency : An Australian experience. In: Internal Medicine Journal. 2007 ; Vol. 37, No. 6. pp. 360-364.
@article{701ef4778b27421f83d1a21e8356b966,
title = "Non-invasive computed tomography angiography in the assessment of coronary stent patency: An Australian experience",
abstract = "Background: This study aimed to evaluate the feasibility and accuracy of 16-slice computed tomography (CT) in the assessment of coronary stent patency. CT coronary angiography (CA) has a high degree of accuracy in the assessment of coronary artery disease compared with invasive selective CA. However, its accuracy in the evaluation of stent patency is not well investigated. Methods: We conducted a retrospective observational study of paired CT coronary angiography (CT-CA) and invasive fluoroscopic coronary angiography (FCA) in 37 patients with 47 coronary stents. CT-CA was carried out with an electrocardiogram-gated 16-slice CT (LightSpeed-16, General Electric (GE), WI, USA). Two CT reporters, blinded to the FCA findings, assessed CT images for stent patency. A cardiologist blinded to CT findings reported FCA. FCA was regarded as the reference standard. Results: A CT-CA could assess 45 of 47 coronary stents (96{\%}). Non-assessable stents on CT-CA were due to motion artefacts and stent-blooming effects. Of those 45 assessable stents, CT-CA correctly identified five out of seven stents with binary in-stent restenosis (ISR) and 37 of 38 stents without binary ISR. The sensitivity and specificity of 16-slice CT in the evaluation of coronary stents for binary ISR were 71{\%} (95{\%} confidence interval (CI) (29{\%}, 96{\%})) and 97{\%} (95{\%}CI (86{\%}, 100{\%})), respectively, exclusive of non-assessable stents. The positive and negative predictive values of 16-slice CT were 83{\%} (95{\%}CI (36{\%}, 100{\%})) and 95{\%} (95{\%}CI (83{\%}, 99{\%})), respectively. Conclusion: Sixteen-slice CT has a low sensitivity, but very a high specificity when compared with FCA in the evaluation of coronary stents for ISR.",
keywords = "In-stent restenosis, Percutaneous coronary intervention",
author = "Soon, {K. H.} and N. Cox and I. Chaitowitz and Selvanayagam, {J. B.} and O. Farouque and L. MacGregor and Bell, {K. W.} and Lim, {Y. L.}",
year = "2007",
month = "6",
doi = "10.1111/j.1445-5994.2007.01363.x",
language = "English (US)",
volume = "37",
pages = "360--364",
journal = "Internal Medicine Journal",
issn = "1444-0903",
publisher = "Wiley-Blackwell",
number = "6",

}

TY - JOUR

T1 - Non-invasive computed tomography angiography in the assessment of coronary stent patency

T2 - An Australian experience

AU - Soon, K. H.

AU - Cox, N.

AU - Chaitowitz, I.

AU - Selvanayagam, J. B.

AU - Farouque, O.

AU - MacGregor, L.

AU - Bell, K. W.

AU - Lim, Y. L.

PY - 2007/6

Y1 - 2007/6

N2 - Background: This study aimed to evaluate the feasibility and accuracy of 16-slice computed tomography (CT) in the assessment of coronary stent patency. CT coronary angiography (CA) has a high degree of accuracy in the assessment of coronary artery disease compared with invasive selective CA. However, its accuracy in the evaluation of stent patency is not well investigated. Methods: We conducted a retrospective observational study of paired CT coronary angiography (CT-CA) and invasive fluoroscopic coronary angiography (FCA) in 37 patients with 47 coronary stents. CT-CA was carried out with an electrocardiogram-gated 16-slice CT (LightSpeed-16, General Electric (GE), WI, USA). Two CT reporters, blinded to the FCA findings, assessed CT images for stent patency. A cardiologist blinded to CT findings reported FCA. FCA was regarded as the reference standard. Results: A CT-CA could assess 45 of 47 coronary stents (96%). Non-assessable stents on CT-CA were due to motion artefacts and stent-blooming effects. Of those 45 assessable stents, CT-CA correctly identified five out of seven stents with binary in-stent restenosis (ISR) and 37 of 38 stents without binary ISR. The sensitivity and specificity of 16-slice CT in the evaluation of coronary stents for binary ISR were 71% (95% confidence interval (CI) (29%, 96%)) and 97% (95%CI (86%, 100%)), respectively, exclusive of non-assessable stents. The positive and negative predictive values of 16-slice CT were 83% (95%CI (36%, 100%)) and 95% (95%CI (83%, 99%)), respectively. Conclusion: Sixteen-slice CT has a low sensitivity, but very a high specificity when compared with FCA in the evaluation of coronary stents for ISR.

AB - Background: This study aimed to evaluate the feasibility and accuracy of 16-slice computed tomography (CT) in the assessment of coronary stent patency. CT coronary angiography (CA) has a high degree of accuracy in the assessment of coronary artery disease compared with invasive selective CA. However, its accuracy in the evaluation of stent patency is not well investigated. Methods: We conducted a retrospective observational study of paired CT coronary angiography (CT-CA) and invasive fluoroscopic coronary angiography (FCA) in 37 patients with 47 coronary stents. CT-CA was carried out with an electrocardiogram-gated 16-slice CT (LightSpeed-16, General Electric (GE), WI, USA). Two CT reporters, blinded to the FCA findings, assessed CT images for stent patency. A cardiologist blinded to CT findings reported FCA. FCA was regarded as the reference standard. Results: A CT-CA could assess 45 of 47 coronary stents (96%). Non-assessable stents on CT-CA were due to motion artefacts and stent-blooming effects. Of those 45 assessable stents, CT-CA correctly identified five out of seven stents with binary in-stent restenosis (ISR) and 37 of 38 stents without binary ISR. The sensitivity and specificity of 16-slice CT in the evaluation of coronary stents for binary ISR were 71% (95% confidence interval (CI) (29%, 96%)) and 97% (95%CI (86%, 100%)), respectively, exclusive of non-assessable stents. The positive and negative predictive values of 16-slice CT were 83% (95%CI (36%, 100%)) and 95% (95%CI (83%, 99%)), respectively. Conclusion: Sixteen-slice CT has a low sensitivity, but very a high specificity when compared with FCA in the evaluation of coronary stents for ISR.

KW - In-stent restenosis

KW - Percutaneous coronary intervention

UR - http://www.scopus.com/inward/record.url?scp=34447101741&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34447101741&partnerID=8YFLogxK

U2 - 10.1111/j.1445-5994.2007.01363.x

DO - 10.1111/j.1445-5994.2007.01363.x

M3 - Article

C2 - 17535378

AN - SCOPUS:34447101741

VL - 37

SP - 360

EP - 364

JO - Internal Medicine Journal

JF - Internal Medicine Journal

SN - 1444-0903

IS - 6

ER -