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Prevalence and prognosis of coronary stent gap detected by multi-detector CT: a follow-up study

European Radiology volume 22, pages 1896–1903 (2012)Cite this article

Abstract

Objectives

To evaluate the features of stent gap (SG) and the long-term impact of SG on in-stent restenosis (ISR) in patent stents.

Methods

A total of 347 consecutive patients with 781 stents who underwent MDCT were assessed for SG and ISR. Clinical and stent features were compared between the SG and non-SG groups. In the follow-up study, among 82 patients with 175 patent stents [26 assessed by conventional coronary angiography (CCA) including 6 contacted in a telephone survey, 46 assessed by computed tomography angiography (CTA) and 10 by both], the incidence of ISR was compared between stents with and without SG.

Results

Three patients and 13 stents were excluded. SG was observed in 12.5% of patients and 8.6% of stents. ISR detected by CTA was noted in 21.2% of SG, and SG accounted for 23.7% of ISR. Stent number, length, location, overlapping pattern, tortuosity and in-out angle were predisposing factors for SG. During a mean follow-up period of 15 months after detection of SG, the incidence of ISR was significantly higher in the SG group than in the non-SG group (43.8/14.9% by CCA, 33.3/10.1% by CTA and CCA).

Conclusion

Patent stents with SG detected by CTA had a higher incidence of late restenosis, indicating that long-term follow-up or further intervention is necessary.

Key Points

• Coronary artery computed tomographic angiography (CTA) is increasingly used following coronary intervention.

• Gaps within coronary stents detected by CTA correlate with in-stent restenosis.

• Patients with stent gaps have more late restenosis at follow-up.

• More attention should be given to patients with stent gaps.

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Abbreviations

SF:

Stent fracture

SG:

Stent gap

CTA:

Computed tomography angiography

CCA:

Conventional coronary angiography

ISR:

In-stent restenosis

SES:

Sirolimus-eluting stent

MDCT:

Multi-detector computed tomography

MIP:

Maximum intensity projection

MPR:

Multi-planar reconstruction

CPR:

Curved-planar reconstruction

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Acknowledgements

The authors would like to thank Dr. Chen, Jiuhong, CT Research Collaboration, Healthcare Sector, Siemens Ltd., China, for her assistance with editing. This research was funded by National Key Technology R&D Program of SPRECA-MDCT. The contract grant number is 2007BAI05B02.

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Authors and Affiliations

  1. Department of Radiology, PLA General Hospital, 28 Fuxing RD, Haidian District, Beijing, 100853, China

    Xinghua Zhang, Li Yang, Haiyue Ju, Fan Zhang & Jian Wu

  2. Department of Cardiology, PLA General Hospital, Beijing, China

    Bin He & Yundai Chen

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  1. Xinghua Zhang
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  2. Li Yang
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  4. Fan Zhang
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  6. Bin He
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  7. Yundai Chen
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Correspondence to Li Yang.

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Zhang, X., Yang, L., Ju, H. et al. Prevalence and prognosis of coronary stent gap detected by multi-detector CT: a follow-up study. Eur Radiol 22, 1896–1903 (2012). https://doi.org/10.1007/s00330-012-2458-6

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  • DOI: https://doi.org/10.1007/s00330-012-2458-6

Keywords

  • X-ray computed tomography
  • Stent
  • Coronary restenosis
  • Prognosis
  • Coronary angiography