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Evaluation of peripheral artery stent with 256 iCT angiography: Comparison with digital subtraction angiography

Abstract
Philips CT Clinical Science Philips Healthcare • USA

Sun X, Wang R, Wen T, Chen X, Yang L, Duan Y, Zhao J, Fu Y.

Purpose
To evaluate the accuracy of 256 iCT angiography in patients with peripheral artery in-stent restenosis, with conventional digital subtraction angiography (DSA) as the reference standard.

Method and Materials
This study was approved by local ethics committee, and written informed consent was obtained from all patients. Between March 2010 and December 2011, a total of 36 patients (31 men, 5 women; mean age, 68.1±8.5 years) with symptomatic peripheral arterial occlusive disease after peripheral artery stent (72 stented lesions) underwent both 256 iCT angiography and conventional DSA. Each stent was classified as evaluable or unevaluable, and every stent was divided into three segments (proximal stent, stent body, and distal stent), resulting in 216 segments. For evaluation, stenosis was graded as follows:
  1. None or slight stenosis (<25%)
  2. Mild stenosis (25-49%)
  3. Moderate stenosis (50-74%)
  4. Severe stenosis or total occlusion (≥75%)
Two readers evaluated all CT angiograms with regard to narrowing of in-stent restenosis by consensus. Results were compared with findings of the DSA.

Results 
Of 72 stents, 58 (80.6%) were determined to be assessable. The metal artifact of the gold marker and motion artifact increased uninterpretability of the images of stents. In evaluable stents, 28 of 32 in-stent restenosis were correctly detected by 256 iCT (87.5% sensitivity). Additionally, there was no significant difference between 256 iCT angiograms and DSA.
 
Conclusion
256 iCT angiography has a high accuracy for the detection of significant in-stent restenosis of assessable stents in patients with peripheral artery stent implantation, and therefore can be considered as a valuable noninvasive technique for stent surveillance.

Clinical Relevance/Application 
256 iCT angiography can be considered as a valuable noninvasive technique for stent surveillance.


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Abstract
iCT
Body, DSA, peripheral runoff CTA, peripheral runoffs, stenosis, stent, Vascular
 

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