What are imaging pearls for coronary computed tomography angiography (CCTA) of coronary artery stents?

Updated: Dec 21, 2017
  • Author: Eugene C Lin, MD; Chief Editor: Eugene C Lin, MD  more...
  • Print
Answer

Answer

Note the following:

  • Contrast opacification of the artery distal to the stent cannot be used as an indicator of stent patency, as collateral vessels may feed the vessel distal to an occluded stent.

  • Edge-enhancing filters can increase spatial resolution and decrease blooming artifact, and they are often helpful in evaluating coronary stents. However, the use of these filters increases image noise. Optimizing intraluminal contrast enhancement can counterbalance increased image noise. [33]

  • It is difficult to evaluate stents in large patients because of increased image noise and decreased vascular opacification. The upper limit of the patient’s body mass index (BMI) should be 35-40 kg/m2. [34]

  • Wide window settings are helpful in evaluating the in-stent lumen. Pugliese et al recommend a window width of 1500 Hounsfield units (HU) and a window center of 300 HU. [33]

  • The positive predictive value of diagnosing in-stent restenosis can be low, particularly in small stents, where false-positive results are often seen. [33]

  • Left main stents are often evaluable due to their relatively large size.

  • Stent fractures can be accurately detected by CCTA. [35]


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!