Case Of the Week (COW) 17 Nov 2013
Answer:
CORONARY STENT(LAD) OCCLUSION.
Findings:
NO OPACIFICATION OF THE IN STENT LUMEN IN THE LEFT ANTERIOR DESCENDING ARTERY IS NOTED , SUGGESTIVE OF OCCLUSION THE STENT STRUTS ARE WELL SEEN WITHOUT OBVIOUS BLOOMING INDICATION EVALUABLE STENT AND GOOD STUDY.
Discussion:
Direct visualization of in stent lumen is crucial to assess stent patency . The segment distal to the occluded stent may be opacified by retrograde filling from collaterals. Occluded stent lumen is darker than contrast enhanced vessel proximal to stent. Wide window settings (window level 300HU and window width 1500HU)- necessary for accurate evaluation of in stent lumen Edge enhancing convolution filters have to be used High concentration contrast agent needed for optimal contrast enhancement. Stainless steel and cobalt stents are better visualized than stents made with other materials. The threshold limit below which stent evaluation for in stent stenosis is low is 3.5mm for 64 slice CT and 3mm for Dual Energy CT Generally stents with low strut thickness of 0.13mm (Taxus stents)were better evaluated.
REF: Assessment of coronary artery stent restenosis by 64-slice multi-detector computed tomography European Heart Journal (2006) 27 , 2567–2572
Contributed By:
Dr. Babu Peter MD, DNB
Associate Professor, Barnard Institute of Radiology
Senior Consultant Radiologist, Aarthi Scans, Chennai
Answer:
CORONARY STENT(LAD) OCCLUSION.
Findings:
NO OPACIFICATION OF THE IN STENT LUMEN IN THE LEFT ANTERIOR DESCENDING ARTERY IS NOTED , SUGGESTIVE OF OCCLUSION THE STENT STRUTS ARE WELL SEEN WITHOUT OBVIOUS BLOOMING INDICATION EVALUABLE STENT AND GOOD STUDY.
Discussion:
Direct visualization of in stent lumen is crucial to assess stent patency . The segment distal to the occluded stent may be opacified by retrograde filling from collaterals. Occluded stent lumen is darker than contrast enhanced vessel proximal to stent. Wide window settings (window level 300HU and window width 1500HU)- necessary for accurate evaluation of in stent lumen Edge enhancing convolution filters have to be used High concentration contrast agent needed for optimal contrast enhancement. Stainless steel and cobalt stents are better visualized than stents made with other materials. The threshold limit below which stent evaluation for in stent stenosis is low is 3.5mm for 64 slice CT and 3mm for Dual Energy CT Generally stents with low strut thickness of 0.13mm (Taxus stents)were better evaluated.
REF: Assessment of coronary artery stent restenosis by 64-slice multi-detector computed tomography European Heart Journal (2006) 27 , 2567–2572
Contributed By:
Dr. Babu Peter MD, DNB
Associate Professor, Barnard Institute of Radiology
Senior Consultant Radiologist, Aarthi Scans, Chennai