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Published on: February 18, 2020
[Noninvasive radiodiagnosis of late coronary stent stenoses]
Insights
Stress echocardiography (stress echoCG) accurately diagnoses coronary stent stenoses and new lesions in stented arteries. Early detection with stress echoCG enables timely, minimally invasive endovascular treatment.
Area of Science:
- Cardiology
- Diagnostic Imaging
- Interventional Cardiology
Context:
- Coronary artery disease management often involves stenting.
- Late in-stent restenosis and de novo lesions pose diagnostic challenges.
- Early detection is crucial for effective treatment and patient outcomes.
Purpose:
- To evaluate the diagnostic utility of stress echocardiography (stress echoCG) for early detection of coronary stent stenoses.
- To assess the accuracy of stress echoCG in identifying both in-stent restenosis and de novo lesions in stented coronary arteries.
Summary:
- This study assessed 39 men with suspected coronary stent stenosis using dobutamine stress echoCG and coronary angiography (CAG).
- Stress echoCG demonstrated 100% sensitivity and diagnostic accuracy for detecting in-stent stenoses and de novo lesions.
- CAG confirmed significant stenoses in 16 patients and moderate stenoses in 12, with 6 developing de novo lesions.
Impact:
- Stress echoCG is a highly effective method for early, site-specific diagnosis of coronary stent stenoses.
- Accurate diagnosis facilitates prompt minimally invasive endovascular interventions.
- Improved diagnostic capabilities can lead to better management of post-stenting complications.
Objective:
To study the diagnostic value of stress echocardiography (stress echoCG) in the early diagnosis of coronary stent stenoses in the late postoperative period.
Subjects And Methods:
The study enrolled 39 men aged 37 to 58 years with symptoms of cardialgia, who had previously (3 to 8 years earlier) undergone balloon angioplasty and coronary artery stenting to treat coronary heart disease. To exclude coronary stent stenoses, all the patients had dobutamine stress echoCG, transesophageal atrial electrostimulation, and further coronary angiographies (CAG).
Results:
Stress echoCG showed a lesion of the stented coronary artery in 34 patients and that of previously angiographically intact coronary arteries in 5 patients. According to CAG data, there was stenosis of > 70% in the coronary stent lumen in 16 patients and that of 40 to 70% in 12 patients. Six patients were found to have de novo stenoses in the previously stented coronary artery. Stress echoCG showed that the diagnostic accuracy and sensitivity of both stenoses of intracoronary stents and de novo ones in the stented artery and previously intact coronary arteries was 100%.
Conclusion:
Stress echoCG is a highly informative method for the early topical diagnosis of both stenoses of coronary stents and a stenotic lesion of previously intact portions of coronary arteries. The early diagnosis of coronary stent stenoses permits mini-invasive endovascular treatment to be performed.
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