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The invisible stent: imaging of an absorbable metal stent with multislice spiral computed tomography
  1. A Y Lind,
  2. H Eggebrecht,
  3. R Erbel

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A 60 year old man was admitted for recurrent stress dependant episodes of chest pain radiating toward the left shoulder for three months. Laboratory tests showed normal troponin I concentrations. During exercise testing the ECG documented significant ST segment depression > 1 mm in V1–V3. Informed consent was obtained and coronary angiography was performed. Examination revealed a single segmental stenosis of the mid left anterior descending coronary artery (LAD) (segment 7, 65% diameter stenosis).

Successful placement of a single absorbable metal stent (AMS) (Biotronik, Bulach, Switzerland) was accomplished in the catheterisation laboratory under fluoroscopic and intravascular ultrasound (IVUS) guidance.

After stent placement a contrast enhanced multislice spiral computed tomography (MSCT) (Somatom Sensation 16, Siemens, Forchheim, Germany) scan was performed using a 500 ms rotation time and 0.75 mm slice thickness during a 30 second breathhold. MSCT demonstrated adequate perfusion throughout the entire LAD without signs of stenosis in the stented area (panel B).

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The AMS therefore overcomes the imaging problems of conventional metallic stents (panel A) and enables reliable direct visualisation of coronary arteries. Thus, non-invasive follow up with MSCT of patients treated with AMS might be feasible for the first time because of adequate differentiation between stent patency, in-stent stenosis, and stent occlusion.