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Multislice CT for assessing in-stent dimensions after left main coronary artery stenting: a comparison with three dimensional intravascular ultrasound
  1. Gerard Roura1,
  2. Josep Gomez-Lara1,
  3. José L Ferreiro1,
  4. Joan A Gomez-Hospital1,
  5. Rafael Romaguera1,
  6. Luís M Teruel1,
  7. Elena Carreño1,
  8. Enric Esplugas1,
  9. Fernando Alfonso2,
  10. Angel Cequier1
  1. 1Interventional Cardiology Unit, Heart Disease Institute, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Spain
  2. 2Interventional Cardiology, Cardiovascular Institute, Hospital San Carlos, Madrid, Spain
  1. Correspondence to Dr Gerard Roura, Interventional Cardiology Unit, Heart Disease Institute, Hospital Universitari de Bellvitge, C/Feixa Llarga s/n, L'Hospitalet de Llobregat, Barcelona 08907, Spain; groura{at}


Objective To evaluate the agreement between multislice CT (MSCT) and intravascular ultrasound (IVUS) to assess the in-stent lumen diameters and lumen areas of left main coronary artery (LMCA) stents.

Design Prospective, observational single centre study.

Setting A single tertiary referral centre.

Patients Consecutive patients with LMCA stenting excluding patients with atrial fibrillation and chronic renal failure.

Interventions MSCT and IVUS imaging at 9–12 months follow-up were performed for all patients.

Main outcome measures Agreement between MSCT and IVUS minimum luminal area (MLA) and minimum luminal diameter (MLD). A receiver operating characteristic (ROC) curve was plotted to find the MSCT cut-off point to diagnose binary restenosis equivalent to 6 mm2 by IVUS.

Results 52 patients were analysed. Passing–Bablok regression analysis obtained a β coefficient of 0.786 (0.586 to 1.071) for MLA and 1.250 (0.936 to 1.667) for MLD, ruling out proportional bias. The α coefficient was −3.588 (−8.686 to −0.178) for MLA and −1.713 (−3.583 to −0.257) for MLD, indicating an underestimation trend of MSCT. The ROC curve identified an MLA ≤4.7 mm2 as the best threshold to assess in-stent restenosis by MSCT.

Conclusions Agreement between MSCT and IVUS to assess in-stent MLA and MLD for LMCA stenting is good. An MLA of 4.7 mm2 by MSCT is the best threshold to assess binary restenosis. MSCT imaging can be considered in selected patients to assess LMCA in-stent restenosis.

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