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Next generation coronary CT angiography: in vitro evaluation of 27 coronary stents

  • Computed Tomography
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Abstract

Objectives

To evaluate in-stent lumen visibility of 27 modern and commonly used coronary stents (16 individual stent types, two stents at six different sizes each) utilising a third-generation dual-source CT system.

Methods

Stents were implanted in a plastic tube filled with contrast. Examinations were performed parallel to the system's z-axis for all stents (i.e. 0°) and in an orientation of 90° for stents with a diameter of 3.0 mm. Two stents were evaluated in different diameters (2.25 to 4.0 mm). Examinations were acquired with a collimation of 96 × 0.6 mm, tube voltage of 120 kVp with 340 mAs tube current. Evaluation was performed using a medium-soft (Bv40), a medium-sharp (Bv49) and a sharp (Bv59) convolution kernel optimised for vascular imaging.

Results

Mean visible stent lumen of stents with 3.0 mm diameter ranged from 53.3 % (IQR 48.9 − 56.7 %) to 73.9 % (66.7 − 76.7 %), depending on the kernel used at 0°, and was highest at an orientation of 90° with 80.0 % (75.6 − 82.8 %) using the Bv59 kernel, strength 4. Visible stent lumen declined with decreasing stent size.

Conclusions

Use of third-generation dual-source CT enables stent lumen visibility of up to 80 % in metal stents and 100 % in bioresorbable stents.

Key Points

• Blooming artefacts impair in–stent lumen visibility of coronary stents in CT angiography.

• CT enables stent lumen visibility of up to 80 % in metal stents.

• Stent lumen visibility varies with stent orientation and size.

• CT angiography may be a valid alternative for detecting in-stent restenosis.

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Acknowledgments

This work was supported by the Comprehensive Heart Failure Center Würzburg. The scientific guarantor of this publication is Tobias Gassenmaier. The authors of this manuscript declare relationships with the following companies: Thomas Allmendinger and Thomas Flohr: employees of Siemens Healthcare. The authors state that this work has not received any funding. No complex statistical methods were necessary for this article. Institutional Review Board approval was not required because no human subjects were involved in this in vitro study. Methodology: experimental.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany

    Tobias Gassenmaier & Thorsten A. Bley

  2. Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany

    Nils Petri & Wolfram Voelker

  3. Siemens Healthcare, Forchheim, Germany

    Thomas Allmendinger & Thomas Flohr

  4. Department of Radiology, University of Cologne, Cologne, Germany

    David Maintz

Authors
  1. Tobias Gassenmaier
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  2. Nils Petri
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  3. Thomas Allmendinger
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  4. Thomas Flohr
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  5. David Maintz
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  6. Wolfram Voelker
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  7. Thorsten A. Bley
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Correspondence to Tobias Gassenmaier.

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Tobias Gassenmaier and Nils Petri have equal contribution

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Gassenmaier, T., Petri, N., Allmendinger, T. et al. Next generation coronary CT angiography: in vitro evaluation of 27 coronary stents. Eur Radiol 24, 2953–2961 (2014). https://doi.org/10.1007/s00330-014-3323-6

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  • DOI: https://doi.org/10.1007/s00330-014-3323-6

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