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Prognostic value of dual-source multidetector computed tomography coronary angiography in patients with stent

Hamza Sunman1, Hikmet Yorgun, Uğur Canpolat

  • 1Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey, hamzasunman@gmail.com.

The International Journal of Cardiovascular Imaging
|May 14, 2013
PubMed

Insights

Dual-source 64-slice multidetector computed tomography (MDCT) effectively predicts outcomes in patients with coronary stents. A patent stent without neointimal hyperplasia (NIH) indicates a good prognosis, while NIH presence signals increased cardiovascular events.

Area of Science:

  • Cardiovascular Imaging
  • Interventional Cardiology
  • Radiology

Background:

  • Coronary artery disease (CAD) management frequently involves stent implantation.
  • Assessing the long-term patency and prognostic value of coronary stents is crucial for patient outcomes.
  • Dual-source 64-slice multidetector computed tomography (MDCT) offers advanced imaging capabilities for evaluating coronary arteries.

Purpose of the Study:

  • To evaluate the prognostic significance of dual-source 64-slice MDCT in patients with coronary stents.
  • To determine the association between stent patency, neointimal hyperplasia (NIH) presence, and major cardiovascular events (MACEs).
  • To establish MDCT as a reliable tool for post-stenting patient evaluation.

Main Methods:

  • Retrospective analysis of 173 patients with prior stent implantation undergoing dual-source 64-slice MDCT.
  • Evaluation of 213 coronary stents for patency and presence/degree of neointimal hyperplasia (NIH).
  • Follow-up for major cardiovascular events (MACEs) associated with the stented segment over a mean of 21.2 months.

Main Results:

  • Patients with a patent stent and no NIH on MDCT showed a high event-free rate (95.2%) over a 2-year follow-up.
  • The presence of nonobstructive or obstructive NIH was associated with an increased rate of MACEs originating from the stented segment.
  • MDCT accurately identified stent patency and NIH, correlating with clinical outcomes.

Conclusions:

  • Dual-source 64-slice MDCT is a reliable tool for assessing coronary stent patency and neointimal hyperplasia.
  • MDCT findings of a patent stent without NIH predict a favorable prognosis in patients post-stenting.
  • MDCT can guide clinical management by identifying patients at higher risk for cardiovascular events due to stent issues.

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