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A 78 year old man came to our hospital because of chest pain on effort. Conventional coronary angiography revealed high grade stenosis at the proximal portion of the left anterior descending branch (LAD). Therefore, percutaneous transluminal coronary angioplasty with metallic stent implantation was performed. Four months after the stent placement, enhanced multislice computed tomography (CT) (Aquilion, Toshiba, Tokyo) was performed with a 1 mm slice thickness, helical pitch 0.8. Following intravenous injection of 100 ml of iodinated contrast material (300 mg/ml), CT scanning was performed with retrospective ECG gated reconstruction. In the maximum intensity projection image, the metallic stent and calcifications were observed in addition to the vessel lumen filled with contrast material. However, it was difficult to evaluate the patency of the proximal portion of the LAD surrounded by the metallic stent, even though the peripheral portion from the implantation site was enhanced. In the volume rendering image in which the vessel lumen filled with contrast material, metallic stent and calcification were observed with the high grade opaque levels, but the patency of the coronary arterial lumen surrounded by the metallic stent could not be evaluated. In another volume rendering image in which metallic stent and calcification were recognised as half transparency and the vessel lumen filled with contrast material was recognised as high grade opaque, the coronary arterial lumen surrounded by the metallic stent could be observed through the half transparent metallic stent.
Conventional coronary angiography was performed and mild diffuse stenosis of the proximal portion of the LAD, at which the metallic stent was located, was observed.