Iliac artery in-stent restenosis evaluation in 64-row CT

摘要

Background: The aim of our study was to assess the sensitivity and accuracy of CTA for the detection of variable degrees of iliac artery in-stent restenosis compared to a DSA.Material and Methods: Twenty patients (39 women – 43% and 51 men – 57%) with suspected iliac in-stent restenosis were pro-spectively evaluated with CTA using a 64 row multidetector CT scanner and DSA examination. The mean patients’ age was 63±6 years (range of 56–81 years of age). DSA and CTA stud?ies were performed during one hospital stay. 90 uncovered im?planted commercially available stents were suspected of in-stent restenosis: 14 stainless steel Express Vascular LD, 26 Wallstent and 50 nitinol Smart. Restenosis in the stented segments were divided into four categories: A – minimal intimal hyperplasia in stented segment 30%; B – hyperplasia obstructing 50% lumen diameter in stented segment; C – hyperplasia obstruct?ing 99% lumen diameter in stented segment and D – occlud?ing intimal hyperplasia in stented segment.Results: It was possible to visualize the stent diameter, lumen and degree of in-stent restenosis.Comparison between CTA and DSA in-stent restenosis B,C, and D groups were identical (sensitivity and specificity were 100%). In group A sensitivity was 100% but specificity was only 80%.Conclusions: In conclusion we have demonstrated that 64 multi?detector CTA is a sensitive and accurate noninvasive vascular imaging investigation to detect in-stent restenosis in the iliac arteries. Final evaluation needs routine post-processing anal?ysis. CTA allows to plan corrective endovascular procedures.