Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Coronary CT Angiography-Based Assessment of Coronary in-Stent Restenosis: A Journey through Past and Present Trends

관상동맥 CT 조영술을 활용한 스텐트 재협착 평가: 과거와 현재 최신 동향으로의 여정

  • Yoon Seong Lee (Department of Radiology, Seoul National University Hospital) ;
  • Eun-Ah Park (Department of Radiology, Seoul National University Hospital) ;
  • Whal Lee (Department of Radiology, Seoul National University Hospital)
  • 이윤성 (서울대학교병원 영상의학과) ;
  • 박은아 (서울대학교병원 영상의학과) ;
  • 이활 (서울대학교병원 영상의학과)
  • Received : 2024.02.16
  • Accepted : 2024.03.08
  • Published : 2024.03.01
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Abstract

Treatment of patients with coronary artery disease commonly involves the use of balloon-expandable stent placements, currently recognized as the most prevalent approach for coronary artery revascularization. Nevertheless, the occurrence of restenosis remains a significant complication following percutaneous coronary interventions. The diagnostic role of coronary CT angiography (CCTA) in detecting stent restenosis has limitations primarily attributable to challenges in accurately discerning the lumen, due to issues such as blooming and motion artifacts. As a result, many cases often necessitate a transition to conventional coronary angiography. However, recent advancements in CT technology have led to notable improvements in both sensitivity and specificity, underscoring the growing significance of CCTA as a diagnostic tool. The consistent reporting of high negative predictive value is particularly noteworthy. This review aims to explore the historical context, current status, and recent trends in diagnosing coronary artery stent restenosis using CCTA.

관상동맥병 환자의 치료에 풍선팽창스텐트 치료는 현재 가장 흔히 시행되는 관상동맥재개통 치료법이다. 그러나 경피적 관상동맥 중재술 이후 재협착은 여전히 주요 합병증으로 남아 있다. 스텐트 재협착을 진단하기 위한 도구로서 관상동맥 CT 조영술(coronary CT angiography; 이하 CCTA)는 과거에는 주로 번짐허상과 움직임허상으로 인해 내강을 정확히 판단하기 어려워 그 역할이 제한적이었다. 따라서 정확한 확인을 위해서 침습적인 고식적 관상동맥 조영술로 넘어가는 경우가 많았다. 그러나 근래 CT 기술의 발달로 민감도와 특이도가 모두 개선되면서 그 역할이 중요해지고 있으며, 특히 일관되게 음성예측도가 높게 보고되고 있다. 본 종설에서는 CCTA를 이용한 관상동맥 스텐트 재협착 진단의 과거와 현재, 그리고 최신 동향에 대해 알아보고자 한다.

Keywords

References

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