CT Imaging of Coronary Stents: Past, Present, and Future.
Level 5 - mechanism / opinion, no new human data
Narrative review without systematic methodology or primary human data
PubMed 22997590 · doi:10.5402/2012/139823
What was done
This review provides an overview of the clinical evidence, historical developments, and current technical capabilities of cardiac CT angiography for evaluating coronary artery stents and detecting in-stent restenosis.
What was found
Coronary CT angiography has a negative predictive value around 98% for ruling out significant in-stent restenosis. It performs best in stents with diameters of 3 mm or greater. Approximately 8% of stents are unassessable due to blooming or motion artifacts, even on modern scanners. New dual-source CT technology enables functional hemodynamic assessments in addition to visual lumen evaluation.
Why it matters
Coronary CT angiography offers an effective noninvasive method to rule out in-stent restenosis in properly selected patients, potentially avoiding unnecessary invasive angiography.
Limits
This is a narrative review rather than a systematic review or meta-analysis. Performance is limited in stents smaller than 3 mm, 8% of cases are unevaluable due to image artifacts, and other diagnostic metrics such as sensitivity and specificity were not reported in the abstract.
Cited by
- context CT coronary angiography causes blooming artifact around preexisting coronary stents, preventing clear visualization inside the stent.