Coronary computed tomography angiography in patients after percutaneous coronary intervention (PCI): Focus on post-processing and visualization techniques

Coronary stent imaging with computed tomography is challenging because of high-density artifacts. However, noninvasive coronary angiography with computed tomography is gaining acceptance as a valid alternative to cardiac catheterization in a broader array of clinical settings, and the work-up of patients after coronary stent implantation represents an application of pressing clinical utility. Only a minority of patients who develop recurrent chest pain after stent implantation have myocardial ischemia, thus a sensitive noninvasive study is desirable. With an awareness of the limitations of the technique, the systematic application of dedicated strategies of data post-processing and display techniques permits partial compensation of the technical limitations brought about by metallic struts. Advances in knowledge: 1. The role of coronary computed tomography angiography in the diagnostic work-up of patients with symptoms after stent placement 2. Systematization of post-processing, display, and review techniques for optimal evalution of coronary stents with coronary computed tomography angiography Summary statement: The follow-up of patients after coronary stenting is an appealing but challenging application of coronary computed tomography angiography. The presence of intrinsic limitations requires the use of dedicated post-processing and visualization techniques.

Keywords: Coronary Angiography - methods, Coronary Restenosis - radiography, Coronary Vessels - surgery, Radiographic Image Enhancement - methods, Stents - adverse effects, Tomography, X-Ray Computed - methods