Detection and analysis of intracoronary artery stent after PTCA using contrast-enhanced three-dimensional electron...

We evaluated several three-dimensional methods of contrast-enhanced electron beam tomography (EBT) for evaluation of intracoronary stent characteristics after percutaneous transluminal coronary angioplasty (PTCA). Twenty-six patients who had undergone PTCA and stenting (31 stents) were investigated by using contrast-enhanced, electrocardiographically (ECG) triggered EBT scanning. EBT results were compared with conventional selective coronary arteriography (SCA). Overall, 27 intracoronary stents had been identified on EBT images (87.1%), while 4 stents could not be evaluated because of impaired image quality. EBT correctly identified the only case in which there was a residual stenosis at the distal portion of the stent. As compared with SCA results, EBT showed an over-estimation of intracoronary stent diameter (p < 0.001) and accurate measurement on the visualized length of the stents (p > 0.05). Fifty Hu, 100 Hu and 150 Hu were used as the observed window levels on three-dimensional (3-D) images; the accuracy for stent assessment increased with ascending window levels. EBT can reliably characterize coronary artery stents and may become a useful non-invasiveive method for patency evaluation of stented coronary segments after PTCA.