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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).
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.