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Cardiac CTA in the Evaluation of Stents

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Coronary Artery CTA

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Abstract

Although the accuracy of stent evaluation with CT is currently being debated, there is general agreement that the CTA has high sensitivity and specificity for greater than 50% stenosis in stents with a diameter of 3 mm or larger. Essentially, deployment of a stent consists of a collapsed wire mesh that is expanded following ballooning of a lesion. The various techniques for stent placement are beyond the scope of this book.

CTA and evaluation of the stent consists of determining whether the stent was completely deployed across a plaque and whether there is a stenosis in the lumen of the stent. The lumen and density in the stent should be similar to that of adjacent artery. Areas of low density in the stent indicate either subintimal hyperplasia or thrombus. This should not be confused with parallel metal artifact from the struts of the stent. The areas of low density in the stent are evaluated similar to how we approach atheromas, with curved reformatted reconstruction and cross-sectional imaging to determine whether they are flow limiting. Additional attention is directed to whether the stent is over- or underexpanded, fractured, angulated, or if it obstructs (cages) a branch. It is also not uncommon to develop a tight stenosis at the edge of the stent (napkin ring stenosis). When a stent is occluded, there is diffuse low density in the lumen of the stent, with a distal low-density transition zone.

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Authors and Affiliations

  1. Department of Radiology, Holy Cross Hospital, South Florida Medical Imaging Cardiovascular Institute, Fort Lauderdale, FL, USA

    Claudio Smuclovisky MD, FACC, FSCCT

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  1. Claudio Smuclovisky MD, FACC, FSCCT
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Correspondence to Claudio Smuclovisky MD, FACC, FSCCT .

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  1. Department of Radiology, Holy Cross Hospital, South Florida Medical Imaging Cardiovascular Institute, Fort Lauderdale, Florida, USA

    Claudio Smuclovisky

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Smuclovisky, C. (2018). Cardiac CTA in the Evaluation of Stents. In: Smuclovisky, C. (eds) Coronary Artery CTA. Springer, Cham. https://doi.org/10.1007/978-3-319-66988-5_9

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  • DOI: https://doi.org/10.1007/978-3-319-66988-5_9

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-66986-1

  • Online ISBN: 978-3-319-66988-5

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