Evaluation of Aortocoronary Bypass Stents with Cardiac MDCT Compared with Conventional Catheter Angiography
Georg Mühlenbruch1,
Andreas H. Mahnken1,2,
Marco Das1,
Rüdiger Blindt3,
Christian Hohl1,
Joachim E. Wildberger1,
Rolf W. Günther1,
Harald P. Kühl3 and
Ralf Koos3
1 Department of Diagnostic Radiology, University Hospital (RWTH) Aachen,
Pauwelsstrasse 30, 52057 Aachen, Germany.
2 Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University,
Aachen, Germany.
3 Department of Cardiology, University Hospital (RWTH) Aachen, 52057 Aachen,
Germany.
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Fig. 1A —55-year-old man with coronary artery disease. Stent had been placed
in middle part of venous right coronary artery bypass graft. Min/Max = minimum
and maximum diameters, measured in millimeters. MDCT images show examples for
planning individually adapted planes orthogonal to vessel course outside and
inside stent.
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Fig. 1B —55-year-old man with coronary artery disease. Stent had been placed
in middle part of venous right coronary artery bypass graft. Min/Max = minimum
and maximum diameters, measured in millimeters. MDCT images show examples for
planning individually adapted planes orthogonal to vessel course outside and
inside stent.
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Fig. 1C —55-year-old man with coronary artery disease. Stent had been placed
in middle part of venous right coronary artery bypass graft. Min/Max = minimum
and maximum diameters, measured in millimeters. Images illustrate how vessel
and stent diameters and attenuation values were determined using MDCT.
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Fig. 1D —55-year-old man with coronary artery disease. Stent had been placed
in middle part of venous right coronary artery bypass graft. Min/Max = minimum
and maximum diameters, measured in millimeters. Images illustrate how vessel
and stent diameters and attenuation values were determined using MDCT.
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Fig. 1E —55-year-old man with coronary artery disease. Stent had been placed
in middle part of venous right coronary artery bypass graft. Min/Max = minimum
and maximum diameters, measured in millimeters. Images illustrate how vessel
and stent diameters and attenuation values were determined using MDCT.
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Fig. 1F —55-year-old man with coronary artery disease. Stent had been placed
in middle part of venous right coronary artery bypass graft. Min/Max = minimum
and maximum diameters, measured in millimeters. Images illustrate how vessel
and stent diameters and attenuation values were determined using MDCT.
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Fig. 2A —Quantitative measurements of vessel and stent diameters in
74-year-old man with coronary artery disease. Invasive coronary angiography
images show measurements corresponding to MDCT (not shown).
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Fig. 2B —Quantitative measurements of vessel and stent diameters in
74-year-old man with coronary artery disease. Invasive coronary angiography
images show measurements corresponding to MDCT (not shown).
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Fig. 2C —Quantitative measurements of vessel and stent diameters in
74-year-old man with coronary artery disease. Invasive coronary angiography
images show measurements corresponding to MDCT (not shown).
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Fig. 3A —Bland-Altman plots of mean vessel diameters, all of which were
measured in millimeters. Mean vessel diameters outside (A) and inside
(B) stent show level of agreement of conventional angiography and
cardiac MDCT angiography. No systematic deviation of data was observed. Solid
lines show means, and dashed lines show SDs.
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Fig. 3B —Bland-Altman plots of mean vessel diameters, all of which were
measured in millimeters. Mean vessel diameters outside (A) and inside
(B) stent show level of agreement of conventional angiography and
cardiac MDCT angiography. No systematic deviation of data was observed. Solid
lines show means, and dashed lines show SDs.
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Fig. 5A —61-year-old man after bypass stent placement 4 years earlier who
presented with atypical chest pain. MDCT angiography images reveal lumen
narrowing in distal part of bypass graft stent (arrows).
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Fig. 5B —61-year-old man after bypass stent placement 4 years earlier who
presented with atypical chest pain. MDCT angiography images reveal lumen
narrowing in distal part of bypass graft stent (arrows).
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Fig. 5C —61-year-old man after bypass stent placement 4 years earlier who
presented with atypical chest pain. Lumen narrowing shown in A and
B was confirmed as in-stent stenosis (arrows) on conventional
angiography. Due to small stent caliber (3 mm), quality of CT images is
hampered right before coronary anastomosis of bypass graft.
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Fig. 5D —61-year-old man after bypass stent placement 4 years earlier who
presented with atypical chest pain. Lumen narrowing shown in A and
B was confirmed as in-stent stenosis (arrows) on conventional
angiography. Due to small stent caliber (3 mm), quality of CT images is
hampered right before coronary anastomosis of bypass graft.
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Fig. 6A —Bar graphs show image noise and CT attenuation values outside and
inside stent. Image noise (A) and CT attenuation (B) values were
1 cm before (pre) and 1 cm after (post), and inside stent. Paired Student's
t tests were applied.
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Fig. 6B —Bar graphs show image noise and CT attenuation values outside and
inside stent. Image noise (A) and CT attenuation (B) values were
1 cm before (pre) and 1 cm after (post), and inside stent. Paired Student's
t tests were applied.
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Copyright © 2007 by the American Roentgen Ray Society.
) and
MDCT (
) compared with mechanical diameter (
) for each stent. In
all 20 stents, 51 positions of in-stent measurements were achievable.