Assessment of Iliac Artery Stent Patency Using Computed Tomography Angiography and Comparison with Digital Subtraction Angiography

Abstract

Abstract

Aim: To investigate the efficacy of axial images obtained after Computed Tomography Angiography (CTA) and images generated by advanced image processing methods to show intimal thickening and stenosis in İliac- intravascular stents.

Materials and methods: Twenty patients who underwent intravascular metallic stent implantation for aortic-iliac artery stenosis at Gazi University Medical Faculty Hospital were analyzed by spiral CTA and digital subtraction angiography (DSA). In addition to axial images, multiplanar reformat (MPR), maximum intensity projection (MIP), shaded surface display (SSD) and virtual intravascular endoscopy (VIE) images were generated to evaluate the stents from the data obtained in spiral CTA examination.  Statistical analyses were performed using the SPSS software package program (IBM), version 20.0. Data are expressed as the arithmetical mean±standard deviation (SD). CTA post procecing techniques were investigated using the chi-square test to assess the relationships between them, and stenosis rates and intimal thickness increase were compared. Our study complied with the Declaration of Helsinki Principles.

Results: In terms of stent lumen visualization, MPR images were more effective than the other images (MIP, SSD, VIE) in evaluating the stent lumen and stenoses.

Conclusion: Spiral CTA in combination with image processing methods can be applied as a noninvasive method to evaluate stent integrity, stent patency, and stent-aorta-iliac artery relationship after intravascular stenting in iliac artery stenoses.