Lots of interesting abstracts and cases were submitted for TCTAP 2022. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!
TCTAP A-056
Diagnostic Performance of Coronary In-stent Restenosis by Coronary Computed Tomography Angiography
By Dong-Gil Kim, Sung Woo Cho, Ji-Won Hwang, Sung Uk Kwon, Jae-Jin Kwak, June Namgung, Sung Yun Lee, Joon-Hyung Doh
Presenter
Dong-Gil Kim
Authors
Dong-Gil Kim1, Sung Woo Cho2, Ji-Won Hwang, Sung Uk Kwon2, Jae-Jin Kwak3, June Namgung2, Sung Yun Lee2, Joon-Hyung Doh2
Affiliation
INJE UNIVERSITY SANGGYE PAIK HOSPITAL, Korea (Republic of)1, Inje University Ilsan Paik Hospital, Korea (Republic of)2, Inje Univ Ilsan Paik Hospital, Korea (Republic of)3
View Study Report
TCTAP A-056
Imaging: Non-Invasive
Diagnostic Performance of Coronary In-stent Restenosis by Coronary Computed Tomography Angiography
Dong-Gil Kim1, Sung Woo Cho2, Ji-Won Hwang, Sung Uk Kwon2, Jae-Jin Kwak3, June Namgung2, Sung Yun Lee2, Joon-Hyung Doh2
INJE UNIVERSITY SANGGYE PAIK HOSPITAL, Korea (Republic of)1, Inje University Ilsan Paik Hospital, Korea (Republic of)2, Inje Univ Ilsan Paik Hospital, Korea (Republic of)3
Background
Coronary in-stent restenosis (ISR) is reported to account for approximately 10% of all percutaneous coronary intervention (PCI) performed. Although ISR is confirmed by coronary angiography (CAG) as a reference standard, several studies have been conducted on the diagnostic accuracy of ISR using coronary computed tomography angiography (CCTA). The results of the diagnostic accuracy of ISR using CCTA in these studies are somewhat different and the explanation for reason of discrepancy between CAG and CCTA is insufficient. Therefore, we investigated the diagnostic reliability of ISR by CCTA and factors affecting the discrepancy between CAG and CCTA.
Methods
Among the patients who underwent PCI from January 1, 2010 to December 31, 2020, 152 patients (269 stents) who performed CAG within 3 months after CCTA were analyzed. In CAG and CCTA, ISR is equally defined as a stenosis greater than 50% of the vessel diameter of within the stented segment or its edge (5-mm segments adjacent to the stent).
Results
According to the performed CAG, ISR was identified in 68 of 269 stents. Among them, the concordance group was 232 (86%) and the discrepancy group was 37 (14%) comparing CCTA. The diagnostic accuracy of ISR by CCTA comparing CAG is that, the sensitivity was 0.66, the specificity was 0.93, the positive predictive value was 0.76 and the negative predictive value was 0.89. The overall accuracy was 86.2% and Cohen’s kappa coefficient (k) (Confidential interval) was 0.62 (0.51 – 0.73). Interpreting the results of analysis, it was confirmed that CCTA had a higher probability of reading patients with the diseases as non-existent. Among the factors affecting discrepancy, stent diameter is significant bigger and left anterior descending artery (LAD) lesion and overlapped stents tended to be more distributed in the discrepancy group compared with the concordance group.
| Table 1. Agreement of ISR diagnosis between CCTA and CAG | |||
| CCTA | CAG | Total | |
| ISR (+) | ISR (-) | ||
| ISR (+) | 45 | 14 | 59 |
| ISR (-) | 23 | 187 | 210 |
| Total | 68 | 201 | 269 |
Conclusion
In the present study, the diagnostic accuracy of ISR by non-invasive CCTA was similar with those of other coronary artery disease diagnoses were obtained. Therefore, CCTA may provide diagnostic value as non-invasive screening tool of ISR after PCI.