64-Slice Computed Tomography Versus Coronary Angiography in Assessment of Stent Pattency

Background: A non-invasive detection of in-stent restenosis (ISR) would result in an easier and safer way to conduct patient follow-up. Objectives: This study sought to evaluate the diagnostic accuracy of 64-slice multislice computed tomography coronary angiography (MSCT) versus invasive coronary angiography (ICA) in follow-up of patients with previous coronary stent implantation. Methods: The study population consists of 50 patients (with 118 stented lesions) presenting for follow-up after previous coronary stent (2.5mm diameter) implantation within at least a period of 6 months up to 1 year regardless the presence or absence of symptoms suggestive of instent restenosis. The diagnostic accuracy of MSCT compared with ICA was evaluated. Results: By ICA, 21 (17%) ISR were diagnosed with a sensitivity, specificity, PPV and NPV of 85.714%, 94.845%, 78.261% and 96.842%. We found that 95 stents (80.5%) screened by MSCT were patent, 92 stents (77.9%) of this total number were seen patent by ICA. While 3 stents (2.5%) of those were seen non patent. Also, 97 stents (82%) of total number of patients taken in this study assessed by ICA were patent, 92 stents (77.9%) of this total number were seen patent by MSCT while 5 stents only (4.2%) were seen non patent by MSCT. Conclusion: 64-MSCT coronary angiography is a very helpful test in excluding patients with coronary instent restenosis.