[Coronary CT Angiography-Based Assessment of Coronary in-Stent Restenosis: A Journey through Past and Present Trends].

Journal of the Korean Society of Radiology Pub Date : 2024-03-01 Epub Date: 2024-03-27 DOI:10.3348/jksr.2024.0026
Yoon Seong Lee, Eun-Ah Park, Whal Lee
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Abstract

Treatment of patients with coronary artery disease commonly involves the use of balloon-expandable stent placements, currently recognized as the most prevalent approach for coronary artery revascularization. Nevertheless, the occurrence of restenosis remains a significant complication following percutaneous coronary interventions. The diagnostic role of coronary CT angiography (CCTA) in detecting stent restenosis has limitations primarily attributable to challenges in accurately discerning the lumen, due to issues such as blooming and motion artifacts. As a result, many cases often necessitate a transition to conventional coronary angiography. However, recent advancements in CT technology have led to notable improvements in both sensitivity and specificity, underscoring the growing significance of CCTA as a diagnostic tool. The consistent reporting of high negative predictive value is particularly noteworthy. This review aims to explore the historical context, current status, and recent trends in diagnosing coronary artery stent restenosis using CCTA.

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[基于冠状动脉 CT 血管造影的冠状动脉支架内再狭窄评估:过去与现在的趋势之旅]。
对冠状动脉疾病患者的治疗通常采用球囊扩张支架植入术,这是目前公认的最普遍的冠状动脉血运重建方法。然而,再狭窄的发生仍然是经皮冠状动脉介入治疗后的一个重要并发症。冠状动脉 CT 血管造影术(CCTA)在检测支架再狭窄方面的诊断作用存在局限性,主要原因是由于花斑和运动伪影等问题,很难准确辨别管腔。因此,许多病例往往需要转为常规冠状动脉造影。然而,CT 技术的最新进展使敏感性和特异性都有了显著提高,凸显了 CCTA 作为诊断工具的重要性与日俱增。尤其值得注意的是,CCTA 的阴性预测值一直很高。本综述旨在探讨使用 CCTA 诊断冠状动脉支架再狭窄的历史背景、现状和最新趋势。
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