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Evaluation of Aortocoronary Bypass Stents with Cardiac MDCT Compared with Conventional Catheter Angiography

¹ Department of Diagnostic Radiology, University Hospital (RWTH) Aachen, Pauwelsstrasse 30, 52057 Aachen, Germany.
² Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany.
³ Department of Cardiology, University Hospital (RWTH) Aachen, 52057 Aachen, Germany.

OBJECTIVE. The objective of our study was to determine the accuracy of 16-MDCT for evaluation of stent patency and in-stent stenosis in venous coronary bypass grafts.

SUBJECTS AND METHODS. Fourteen patients who had previous stent placements in stenosed venous coronary bypass grafts underwent contrast-enhanced MDCT of the heart (collimation, 16 x 0.75 mm; 120 kV; 550 mAs_eff) and invasive coronary angiography. A total of 20 stents were evaluated: Vessel and stent diameters proximal to, distal to, and at various sites inside the stent were measured on both techniques, and Bland-Altman plots and correlations were calculated. Image noise and image quality were also assessed applying a Student's t test for data comparison of image noise.

RESULTS. All 20 bypass stents were correctly classified as patent. Vessel diameters outside the stent showed an excellent correlation (r = 0.90) and in-stent diameters showed a good correlation (r = 0.72), with lower values for MDCT due to blooming artifacts. All significant in-stent stenoses were correctly classified.

CONCLUSION. In patients suspected of bypass in-stent stenosis, 16-MDCT may be considered as a valuable alternative to conventional angiography for evaluating bypass patency and in-stent stenosis.

Keywords: cardiac imaging • catheter angiography • conventional angiography • coronary artery disease • CT angiography • heart • MDCT • stents

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