Jin Qinhua

Accuracy of 128-slice dual-source CT using high-pitch spiral mode for the assessment of coronary stents: first in vivo experience.

OBJECTIVE To investigate the accuracy of 128-slice dual-source CT using high-pitch spiral mode (HPS) for the assessment of coronary stents. METHODS We conducted a prospective study on patients with previous stent implantation due to recurred suspicious symptoms of angina with positive findings at stress testing scheduled for coronary angiography (CA), while dual source computed tomography (DSCT) examinations were randomly done by one of the three different scan modes [HPS, sequential mode (SEQ), low-pitch spiral mode (LPS)] one week before CA examinations. The image quality, radiation dose and stent patency of DSCT were evaluated blinded to the results of CA. RESULTS 180 patients with total 256 stents were enrolled in this study. There was no significant difference on the image quality of DSCT by HPS (1.4±0.5), SEQ (1.5±0.5) and LPS (1.3±0.6) (P>0.05). The noise of images reconstructed with B26f kernel in HPS is significantly increased than in SEQ/LPS (P<0.05), while no significant difference with images reconstructed with B46f kernel (P>0.05). Heart rate (HR) variability had a slight impact on the image quality for HPS (P<0.05), not for LPS/SEQ (P>0.05). In the assessment of stent restenosis compared with CA on per-stent basis, there was no significant difference on sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of DSCT using HPS (100%, 97.1%, 83.3%, 100%), LPS (92.3%, 95.9%, 80%, 98.6%) and SEQ (93.3%, 97.3%, 87.5%, 98.6%) (P>0.05). The effective dose of DSCT by HPS (1.0±0.5mSv) is significant less than that by SEQ (3.0±1.4mSv) or LPS (13.0±5.4mSv) (P<0.01). CONCLUSIONS DSCT using HPS provides good diagnostic accuracy on coronary stent patency compared with CA, similar to that by SEQ/LPS, whereas with lower effective dose in patients with HR lower than 65bpm.

e0320 Impact of plaque morphology on intimal hyperplasia after stenting assessed by optical coherence tomography

Objective The objective of this study was to evaluate whether the plaque morphology can affect the in-stent neointimal hyperplasia. Methods 74 patients (93 stents) with OCT post-stent implantation were included in the study. Cross-sectional OCT images were analysed at 1-mm intervals (every 15 frames), and 302 cross-sectional images with lipid or calcific lesions under the stent struts were selected. The struts in these sections were divided into four groups according to the plaque conditions under the struts: group 1—struts on the normal vessel, group 2—on the fibrotic lesion, group 3—on the calcific lesion, group 4—on the lipid rich lesion. The neointimal hyperplasia thickness on the stent struts were measured by OCT. Results The plaque conditions under 806 struts could be detected clearly by OCT. Among them, 157 struts were on the normal vascular wall (the intimal thickness were less than 250 μm by OCT), 344 struts were on the fibrotic lesions, 145 struts on calcific lesions and 160 struts on lipid lesions. The neointimal thickness were 0.132±0.081 μm, 0.148±0.091 μm, 0.150±0.105 μm and 0.166±0.088 μm respectively in group 1–4. The p value was 0.011. Conclusions The plaque type has impact on the in-stent neointimal hyperplasia. The underlying lipid or calcific components in plaque may promote neointimal hyperplasia after stent implantation.

GW25-e0731 The Triage of Coronary Artery Occlusion and its Long-term Prognosis-A Propensity-Matched Study

Without doubt the immediate angiographic results of coronary occlusion are dramatic. The occluded artery becomes patent almost instantaneously after balloon dilatation. However, the long-term outcomes remain in dispute. It is especially true when the comparison was made between successful and failed

GW25-e5158 Serum Cystatin C Level Not Associated with Coronary Artery Plaque Vulnerability Analyzed by Optical Coherence Tomography

Cystatin C, which is an endogenous marker for renal function, is reported to be a novel marker for coronary atherosclerosis. Some studies showed that lower cystatin C levels may be associated with increased severity of CAD in clinically stable patients, whereas higher levels may indicate the