Coronary stent evaluation with computed tomography coronary angiography

C-0322 Coronary stent evaluation with computed tomography coronary angiography: comparison between Iomeprol-400 and Iodixanol-320

S. Mushtaq, D. Andreini, G. Pontone, E. Conte, E. Bertella, A. Baggiano, A. Formenti, G. Ballerini, M. Pepi; Milan/IT

DOI: 10.1594/ecr2013/C-0322


Multi-detector computed tomography coronary angiography (MDCT-CA) is becoming an increasingly widespread tool for the non-invasive evaluation of coronary arteries, stents and bypass grafts (1). Although good diagnostic accuracy has been demonstrated for native coronary arteries and bypass grafts, beam-hardening artifacts resulting from metallic struts may preclude accurate quantification of neointimal hyperplasia and coronary stent narrowing. Although single-center studies with 64-slice...

Methods and Materials

Three-hundred consecutive patients with previous coronary stent implantation who were scheduled for non-invasive coronary imaging follow-up with MDCT-CA between July 2011 and June 2012 were considered for inclusion in this study.  A total of 22 patients were excluded due to breath-holding inability (6 patients), impaired renal function (10 patients) and cardiac arrhythmias (6 patients). Therefore, 278 patients were divided into 3 groups using a computer-generated randomised...


The three groups were homogeneous in terms of gender, age, BMI, prevalence of cardiovascular risk factors and serum creatinine. No significant differences were also found in intravenous or oral b-blockade pre-treatment and stent characteristics. At least one stent with significant ISR at MDCT-CA was found in 36 patients of group 1, in 31 patients of group 2 and in 35 patients of group 3. The HR before imaging was similar in the 3 groups. On the contrary, the HR after imaging was significantly...


The main finding of the study is that Iodixanol-320 provided better image quality allowing higher evaluability of coronary stents in comparison to Iomeprol-400 when the two CM were injected at the same flow rate. This was the result of a significant reduction of the beam-hardening effect, which often leads to artifacts that may preclude accurate assessment of coronary stent lumen. Moreover, Iodixanol-320 decreased heat sensation, reduced PHB number and minimized the effect of CM injection on...


  1. Achenbach S. Computed tomography coronary angiography. J Am Coll Cardiol 2006;48:1919-1928. Review.
  2. Rixe J, Achenbach S, Ropers D, et al. Assessment of coronary artery stent restenosis by 64-slice multi-detector computed tomography. Eur Heart J 2006;27:2567-2572.
  3. Ehara M, Kawai M, Surmely JF, et al. Diagnostic accuracy of coronary in-stent restenosis using 64-slice computed tomography: comparison with invasive coronary...

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