Multidetector Computed Tomography Coronary Angiography for the Assessment of Coronary In-Stent Restenosis

The investigators conducted a review to evaluate the diagnostic performance of multidetector computed tomography (MDCT) for coronary stent evaluation. The prespecified inclusion criteria selected prospective or retrospective human studies published in English. Studies that did not report raw numbers of diagnostic accuracy for the detection of in-stent restenosis were excluded. The data from 24 studies are reported, 6 performed with old-generation scanners (4-, 16-, and 40-slice MDCT) and 18 performed with 64-slice MDCT or dual-source MDCT. With old-generation MDCT, up to 18% of coronary stents were missed, the rate of nonevaluable stents ranged from 2.6% to 23.5%, and the overall feasibility and diagnostic accuracy were 90.4% and 90%, respectively. With 64-slice MDCT, no stent was missed, and the overall feasibility and diagnostic accuracy were 90.4% and 91.9%, respectively. Advancements in MDCT and stent technologies may further reduce the number of nonassessable stents and improve diagnostic performance.