Comparison between four-slice computed tomography and coronary angiography for the assessment of coronary stents

The present study aimed to evaluate the diagnostic accuracy of four-slice computed tomography for the detection, localization and patency assessment of metal coronary stents in a general population referred for coronary angiography late after coronary angioplasty.

Twenty-four consecutive patients with 34 coronary stents underwent multislice computed tomography within 24 h before a clinically driven coronary angiography performed 245 +/- 92 days after coronary stent implantation. For each patient, two independent operators were asked to evaluate the overall number of stents, the treated coronary vessels and segments, the presence of side-branches in the stented segment, the vessel patency, and the presence of binary in-stent restenosis.

Four-slice computed tomography was feasible in 23 out of 24 patients (96%). Diagnostic accuracy was 94% for stent detection, 96% for the recognition of the stented coronary vessel and 97% for the identification of the stented segment. Accuracy in detection of side-branches in the stented segment, vessel patency and in-stent restenosis was 86%, 88% and 50%, respectively.

Four-slice computed tomography is accurate in the identification of the stented coronary vessel and segment. By contrast, accuracy is low in the detection of vessel patency and in-stent restenosis. Such a technique does not appear to be useful as a screening tool before invasive diagnostic procedures.