Stent size selection using 64-detector coronary computed tomography angiography: a comparison to invasive coronary...

Compare stent size selection using coronary computed tomography angiography (CCTA) to invasive coronary angiography (ICA). CCTA is increasingly performed before cardiac catheterization; however, the utility of incorporating these data into coronary interventions is unknown.

Retrospective study of 18 consecutive patients with 24 coronary artery lesions evaluated with 64-detector CCTA followed by ICA and resulting stent placement. Two blinded interventional cardiologists independently reviewed designated arterial segments on both CCTA and ICA during different reading sessions and determined anticipated stent length and nominal diameter, maximum stenosis, the need for postdilation of either stent margin, and final proximal and distal stent diameters.

There was strong correlation between CCTA and ICA in the anticipated stent length (r = 0.85, P < .001) and final stent diameter (proximal end r = 0.74, P < .001; distal end r = 0.63, P = .001). Anticipated stent length was longer with CCTA compared to ICA (27.0 +/- 16.0 vs. 21.8 +/- 13.3 mm; P = .006). The final stent diameters were larger with CCTA compared to ICA, both at the proximal end (3.6 +/- 0.5 vs. 3.1 +/- 0.5 mm; P < .001) and distal end (3.2 +/- 0.6 vs. 2.9 +/- 0.4 mm; P = .004).

Using 64-detector CCTA, interventional cardiologists select longer stents with larger final stent diameters than with ICA. Further studies are needed to determine the clinical utility of incorporating CCTA, when available, in defining interventional strategy.