Angiographic CT: in vitro comparison of different carotid artery stents using two different angiography systems.

BACKGROUND AND PURPOSE Our aim was to evaluate the in vitro visualization of different carotid artery stents on Angiographic CT (ACT). Of particular interest was the measurement of artificial lumen narrowing (ALN) caused by the stent material within the stented vessel segment to determine whether ACT can be used to detect restenosis within the stent. MATERIAL AND METHODS ACT appearances of 17 carotid artery stents of different designs and sizes (4.0 to 11.0 mm) were investigated in vitro. All stents were imaged on two different angiography systems. For each stent, artificial lumen narrowing (ALN) was calculated. RESULTS The ALN on the two different angiography systems did not significantly differ. With standard algorithm image reconstruction, ALN ranged from 19.1 to 46.6%. With stent-optimized algorithm image reconstruction, ALN was significantly lower and ranged from 7.6 to 17.2%. Different stents showed significantly different degree of ALN. Stent struts could be visualized in all stents. CONCLUSION In our in vitro model, ACT evaluation of vessel patency after stent placement is possible but is impaired by ALN. Stent-optimized algorithm image reconstruction decreases ALN but further research is required to define the visibility of in-stent stenosis depending on image reconstruction.

[1]  M. Hartmann,et al.  Small-vessel stents for intracranial angioplasty: in vitro comparison of different stent designs and sizes by using CT angiography. , 2003, AJNR. American journal of neuroradiology.

[2]  P. D. De with,et al.  High-resolution 3D X-ray imaging of intracranial nitinol stents , 2011, Neuroradiology.

[3]  Optimal carotid artery coverage for carotid plaque CT-imaging in predicting ischemic stroke. , 2010, Journal of neuroradiology. Journal de neuroradiologie.

[4]  W. Hacke,et al.  Results of the Stent-Protected Angioplasty versus Carotid Endarterectomy (SPACE) study to treat symptomatic stenoses at 2 years: a multinational, prospective, randomised trial , 2008, The Lancet Neurology.

[5]  A. Alexandrov,et al.  The clinical value of methods to measure carotid stenosis. , 1996, International angiology : a journal of the International Union of Angiology.

[6]  Charles M Strother,et al.  Increased Cell Opening and Prolapse of Struts of a Neuroform Stent in Curved Vasculature: Value of Angiographic Computed Tomography: Technical Case Report , 2006, Neurosurgery.

[7]  Mircea Ionescu,et al.  Spatial resolution limits of multislice computed tomography (MS-CT), C-arm-CT, and flat panel-CT (FP-CT) compared to MicroCT for visualization of a small metallic stent. , 2011, Academic radiology.

[8]  Rainer Raupach,et al.  64-slice multidetector coronary CT angiography: in vitro evaluation of 68 different stents , 2006, European Radiology.

[9]  T. Struffert,et al.  Flat-detector computed tomography in the assessment of intracranial stents: comparison with multi detector CT and conventional angiography in a new animal model , 2011, European Radiology.

[10]  M. Knauth,et al.  Angiographic CT with intravenous administration of contrast medium is a noninvasive option for follow-up after intracranial stenting , 2008, Neuroradiology.

[11]  M. Koltzenburg,et al.  Silent embolism in diagnostic cerebral angiography and neurointerventional procedures: a prospective study , 1999, The Lancet.

[12]  Hesham Morsi,et al.  Angiographic CT in cerebrovascular stenting. , 2005, AJNR. American journal of neuroradiology.

[13]  Carotid Artery Stents: In Vitro Comparison of Different Stent Designs and Sizes Using CT Angiography and Contrast-Enhanced MR Angiography at 1.5T and 3T , 2009, American Journal of Neuroradiology.

[14]  C Pachai,et al.  Overestimation of moderate carotid stenosis assessed by both Doppler US and contrast enhanced 3D-MR angiography in the CARMEDAS study. , 2011, Journal of neuroradiology. Journal de neuroradiologie.

[15]  M. Knauth,et al.  Angiographic CT after Intravenous Contrast Agent Application: A Noninvasive Follow-Up Tool after Intracranial Angioplasty and Stenting , 2010, American Journal of Neuroradiology.

[16]  N. Noordhoek,et al.  Contrast-Enhanced Angiographic Cone-Beam CT of Cerebrovascular Stents: Experimental Optimization and Clinical Application , 2010, American Journal of Neuroradiology.

[17]  M. Völk,et al.  Appearance of Vascular Stents in Computed Tomographic Angiography: In Vitro Examination of 14 Different Stent Types , 2001, Investigative radiology.

[18]  T. Struffert,et al.  Angiographic CT with intravenous contrast agent application for monitoring of intracranial flow diverting stents , 2012, Neuroradiology.

[19]  S. Heiland,et al.  In vitro comparison of different carotid artery stents: a pixel-by-pixel analysis using CT angiography and contrast-enhanced MR angiography at 1.5 and 3 T , 2010, Neuroradiology.

[20]  F. Lazeyras,et al.  ADC mapping of chronic cerebral hypoperfusion induced by carotid artery stenosis. , 2011, Journal of neuroradiology. Journal de neuroradiologie.

[21]  Marc Saake,et al.  Optimized intravenous Flat Detector CT for non-invasive visualization of intracranial stents: first results , 2011, European Radiology.