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ISRN Cardiology
Volume 2012 (2012), Article ID 139823, 12 pages
http://dx.doi.org/10.5402/2012/139823
Review Article

CT Imaging of Coronary Stents: Past, Present, and Future

Department of Diagnostic and Interventional Radiology, University Hospital, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany

Received 25 July 2012; Accepted 16 August 2012

Academic Editors: F. Cademartiri and S.-J. Park

Copyright © 2012 Andreas H. Mahnken. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Coronary stenting became a mainstay in coronary revascularization therapy. Despite tremendous advances in therapy, in-stent restenosis (ISR) remains a key problem after coronary stenting. Coronary CT angiography evolved as a valuable tool in the diagnostic workup of patients after coronary revascularization therapy. It has a negative predictive value in the range of 98% for ruling out significant ISR. As CT imaging of coronary stents depends on patient and stent characteristics, patient selection is crucial for success. Ideal candidates have stents with a diameter of 3 mm and more. Nevertheless, even with most recent CT scanners, about 8% of stents are not accessible mostly due to blooming or motion artifacts. While the diagnosis of ISR is currently based on the visual assessment of the stent lumen, functional information on the hemodynamic significance of in-stent stenosis became available with the most recent generation of dual source CT scanners. This paper provides a comprehensive overview on previous developments, current techniques, and clinical evidence for cardiac CT in patients with coronary artery stents.