Stent Gaps Detected by Computed Tomographic Angiography

In a retrospective case series, stent gaps were more common than expected and associated with in-stent restenosis.

Although drug-eluting stents (DES) have reduced the rate of in-stent restenosis (ISR) compared with bare-metal stents, ISR occurs even in some DES recipients. To explore whether stent fractures undetected by coronary angiography might contribute to ISR in these patients, investigators examined 64-detector computed tomographic angiograms (CTA) of 292 patients with 613 stents for partial or complete stent gaps. Each gap was first located visually then confirmed by a radiodensity finding of <300 Hounsfield units, which correlates with the absence of metal, at the site. Coronary angiograms were available for comparison for 143 of the patients.

CTAs showed stent gaps in 14% of all patients. In patients who also had coronary angiograms, gaps were …

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI