Portal de Periódicos da CAPES

Multislice Spiral Computed Tomography for In-Stent Restenosis

2002; Lippincott Williams & Wilkins; Volume: 105; Issue: 16 Linguagem: Inglês

10.1161/01.cir.0000013305.01850.37

1524-4539

Maria Luigia Storto, Riccardo Marano, Nicola Maddestra, Massimo Caputo, Marco Zimarino, Lorenzo Bonomo,

Advanced X-ray and CT Imaging

HomeCirculationVol. 105, No. 16Multislice Spiral Computed Tomography for In-Stent Restenosis Free AccessReview ArticlePDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessReview ArticlePDF/EPUBMultislice Spiral Computed Tomography for In-Stent Restenosis Maria Luigia Storto, Riccardo Marano, Nicola Maddestra, Marcello Caputo, Marco Zimarino and Lorenzo Bonomo Maria Luigia StortoMaria Luigia Storto From the Department of Clinical Sciences and Bioimaging, University of Chieti, Italy. , Riccardo MaranoRiccardo Marano From the Department of Clinical Sciences and Bioimaging, University of Chieti, Italy. , Nicola MaddestraNicola Maddestra From the Department of Clinical Sciences and Bioimaging, University of Chieti, Italy. , Marcello CaputoMarcello Caputo From the Department of Clinical Sciences and Bioimaging, University of Chieti, Italy. , Marco ZimarinoMarco Zimarino From the Department of Clinical Sciences and Bioimaging, University of Chieti, Italy. and Lorenzo BonomoLorenzo Bonomo From the Department of Clinical Sciences and Bioimaging, University of Chieti, Italy. Originally published23 Apr 2002https://doi.org/10.1161/01.CIR.0000013305.01850.37Circulation. 2002;105:2005A 72-year-old man was admitted for recurrent episodes of chest pain 3 months after stent deployment in the left anterior descending (LAD) artery. The patient underwent a computerized tomographic (CT) examination of the thorax with a multislice spiral CT scanner (MSCT) (Somatom Volume Zoom, Siemens). A dynamic study was performed with acquisition of 20 scans at the level of the LAD distal to the stented segment during injection of 20 mL of nonionic contrast medium (370 mgI/mL); the resultant time-density curves were suggestive of high-grade stenosis (Figure 1A). Thereafter, a cardiac CT scan with retrospective electrocardiographic gating and injection of 110 mL of contrast medium was performed. Axial images were reconstructed with an absolute delay of 400 ms before the next R-wave. Three-dimensional volume-rendered images were also obtained; 2 overlapping stents were identified in the mid LAD without lumen reduction at the margins (Figures 2A and 2B). Coronary angiography documented a subocclusive in-stent restenosis, with TIMI (thrombolysis in myocardial infarction) grade 2 flow in the LAD. Rotational atherectomy followed by adjunctive angioplasty was performed, without residual stenosis. Before discharge, the patient underwent a second MSCT scan, which showed good opacification of LAD distal to the stented segment, whereas the repeated time-density curves were consistent with the absence of stenosis in LAD (Figure 1B). Although an accurate evaluation of in-stent lumen remains problematic, MSCT is a promising noninvasive technique that may provide useful information on stent localization, functional relevance of in-stent restenosis, and the status of coronary lumen close to stent margins. Download figureDownload PowerPointFigure 1. MSCT dynamic study. A, Compared with the ascending Aorta, distal LAD artery time-density curve showed a slower slope and a delayed peak density, suggestive of high-grade stenosis. HU indicates Hounsfield Units. B, After repeat percutaneous intervention, the two curves paralleled, documenting absence of residual stenosis.Download figureDownload PowerPointFigure 2. MSCT images. A, CT axial scan through the aortic root showed 2 stents in the mid left anterior descending (LAD); total length was 23 mm (dotted line) with a 3-mm overlapping segment (solid line). B, 3-D rendering of the heart and coronary arteries with manual segmentation of cross-sectional images. Left coronary system can be identified. LMCA indicates left main coronary artery; LCx, left circumflex; 1stD, 1st diagonal branch; and GCV, great cardiac vein. The stented segment (arrow) is localized in the mid LAD.The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke's Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.Circulation encourages readers to submit cardiovascular images to the Circulation Editorial Office, St Luke's Episcopal Hospital/Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.FootnotesCorrespondence to Maria Luigia Storto, MD, Dept of Clinical Sciences and Bioimaging, Section of Radiology, SS.Annunziata Hospital, University of Chieti, Via dei Vestini, 66100 Chieti, Italy. E-mail [email protected] Previous Back to top Next FiguresReferencesRelatedDetailsCited By Zimarino M, Marano R, Radico F, Curione D and De Caterina R (2018) Coronary computed tomography angiography, ECG stress test and nuclear imaging as sources of false-positive results in the detection of coronary artery disease, Journal of Cardiovascular Medicine, 10.2459/JCM.0000000000000591, 19, (e133-e138), Online publication date: 1-Feb-2018. Zimarino M, Montebello E, Radico F, Gallina S, Perfetti M, Iachini Bellisarii F, Severi S, Limbruno U, Emdin M and De Caterina R (2016) ST segment/heart rate hysteresis improves the diagnostic accuracy of ECG stress test for coronary artery disease in patients with left ventricular hypertrophy, European Journal of Preventive Cardiology, 10.1177/2047487316655259, 23:15, (1632-1639), Online publication date: 1-Oct-2016. Zimarino M, Prati F, Marano R, Angeramo F, Pescetelli I, Gatto L, Marco V, Bruno I and De Caterina R (2016) The value of imaging in subclinical coronary artery disease, Vascular Pharmacology, 10.1016/j.vph.2016.02.001, 82, (20-29), Online publication date: 1-Jul-2016. Radico F, Cicchitti V, Zimarino M and De Caterina R (2014) Angina Pectoris and Myocardial Ischemia in the Absence of Obstructive Coronary Artery Disease: Practical Considerations for Diagnostic Tests, JACC: Cardiovascular Interventions, 10.1016/j.jcin.2014.01.157, 7:5, (453-463), Online publication date: 1-May-2014. Moniuszko A and Kesala B (2014) Practice Test #3: Difficulty Level—Hard Nuclear Cardiology Study Guide, 10.1007/978-1-4614-8645-9_4, (157-233), . Ricci F, Radico F, Zimarino M, Marano R and De Caterina R (2013) Minimally aggressive treatment of spontaneous coronary artery dissections, Journal of Cardiovascular Medicine, 10.2459/JCM.0b013e3283529014, 14:2, (166-167), Online publication date: 1-Feb-2013. Mahnken A (2012) CT Imaging of Coronary Stents: Past, Present, and Future, ISRN Cardiology, 10.5402/2012/139823, 2012, (1-12), Online publication date: 11-Sep-2012. Zimarino M, Corcos T, Bramucci E and Tamburino C (2012) Rotational atherectomy: A "survivor" in the drug-eluting stent era, Cardiovascular Revascularization Medicine, 10.1016/j.carrev.2012.03.002, 13:3, (185-192), Online publication date: 1-May-2012. Mühlenbruch G, Mahnken A, Das M, Blindt R, Hohl C, Wildberger J, Günther R, Kühl H and Koos R (2007) Evaluation of Aortocoronary Bypass Stents with Cardiac MDCT Compared with Conventional Catheter Angiography, American Journal of Roentgenology, 10.2214/AJR.06.0120, 188:2, (361-369), Online publication date: 1-Feb-2007. Ohnuki K, Yoshida S, Ohta M, Shimizu M, Mochizuki S, Nishioka M, Sakuma T, Fukuda K, Ishizaki M, Hirakawa E and Andou T (2006) New diagnostic technique in multi-slice computed tomography for in-stent restenosis: Pixel count method, International Journal of Cardiology, 10.1016/j.ijcard.2005.05.013, 108:2, (251-258), Online publication date: 1-Apr-2006. Seifarth H, Özgün M, Raupach R, Flohr T, Heindel W, Fischbach R and Maintz D (2006) 64- Versus 16-Slice CT Angiography for Coronary Artery Stent Assessment, Investigative Radiology, 10.1097/01.rli.0000191365.88345.e1, 41:1, (22-27), Online publication date: 1-Jan-2006. Gaspar T, Halon D, Lewis B, Adawi S, Schliamser J, Rubinshtein R, Flugelman M and Peled N (2005) Diagnosis of Coronary In-Stent Restenosis With Multidetector Row Spiral Computed Tomography, Journal of the American College of Cardiology, 10.1016/j.jacc.2005.07.049, 46:8, (1573-1579), Online publication date: 1-Oct-2005. Seifarth H, Raupach R, Schaller S, Fallenberg E, Flohr T, Heindel W, Fischbach R and Maintz D (2005) Assessment of coronary artery stents using 16-slice MDCT angiography: evaluation of a dedicated reconstruction kernel and a noise reduction filter, European Radiology, 10.1007/s00330-004-2594-8, 15:4, (721-726), Online publication date: 1-Apr-2005. Becker C Multidetector-Row CT Angiography of the Coronary Arteries Multidetector-Row CT Angiography, 10.1007/3-540-26984-3_9, (125-136) Becker C and Knez A (2004) Past, present, and future perspective of cardiac computed tomography, Journal of Magnetic Resonance Imaging, 10.1002/jmri.20072, 19:6, (676-685), Online publication date: 1-Jun-2004. White R (2004) MR and CT assessment for ischemic cardiac disease, Journal of Magnetic Resonance Imaging, 10.1002/jmri.20068, 19:6, (659-675), Online publication date: 1-Jun-2004. Leta R, Carreras F, Alomar X, Monell J, García-Picart J, Augé J, Salvador A and Pons-Lladó G (2004) Non-Invasive Coronary Angiography With 16 Multidetector-Row Spiral Computed Tomography: a Comparative Study With Invasive Coronary Angiography, Revista Española de Cardiología (English Edition), 10.1016/S1885-5857(06)60139-4, 57:3, (217-224), Online publication date: 1-Mar-2004. Mahnken A, Buecker A, Wildberger J, Ruebben A, Stanzel S, Vogt F, Günther R and Blindt R (2004) Coronary Artery Stents in Multislice Computed Tomography, Investigative Radiology, 10.1097/01.rli.0000095471.91575.18, 39:1, (27-33), Online publication date: 1-Jan-2004. Leta R, Carreras F, Alomar X, Monell J, García-Picart J, Augé J, Salvador A and Pons-Lladó G (2004) Coronariografía no invasiva mediante tomografía computarizada con 16 detectores: estudio comparativo con la angiografía coronaria invasiva, Revista Española de Cardiología, 10.1016/S0300-8932(04)77093-1, 57:3, (217-224), Online publication date: 1-Jan-2004. Achenbach S, Ropers D, Pohle K, Anders K, Baum U, Hoffmann U, Moselewski F, Ferencik M and Brady T (2003) Clinical results of minimally invasive coronary angiography using computed tomography, Cardiology Clinics, 10.1016/S0733-8651(03)00090-0, 21:4, (549-559), Online publication date: 1-Nov-2003. Morgan-Hughes G, Marshall A and Roobottom C (2003) Multislice Computed Tomographic Coronary Angiography: Experience in a UK Centre, Clinical Radiology, 10.1016/S0009-9260(03)00051-5, 58:5, (378-383), Online publication date: 1-May-2003. April 23, 2002Vol 105, Issue 16 Advertisement Article InformationMetrics https://doi.org/10.1161/01.CIR.0000013305.01850.37PMID: 11997291 Originally publishedApril 23, 2002 PDF download Advertisement