Stenosis > 50% diameter reduction of coronary artery lumen inside or at edges of implanted stent
2 different morphologies
Focal ISR: Short stenosis anywhere within stent
Diffuse ISR: Stenosis along entire length of implanted stent
IMAGING
CT Findings
MR Findings
Echocardiographic Findings
Angiographic Findings
Nuclear Medicine Findings
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Dai T et al: Diagnostic performance of computed tomography angiography in the detection of coronary artery in-stent restenosis: evidence from an updated meta-analysis. Eur Radiol. 28(4):1373-82, 2018
Mannil M et al: Photon-Counting CT: High-Resolution Imaging of Coronary Stents. Invest Radiol. 53(3):143-9, 2018
Bangalore S et al: The state of the absorb bioresorbable scaffold: consensus from an expert panel. JACC Cardiovasc Interv. 10(23):2349-59, 2017
Hickethier T et al: Monoenergetic reconstructions for imaging of coronary artery stents using spectral detector CT: In-vitro experience and comparison to conventional images. J Cardiovasc Comput Tomogr. 11(1):33-9, 2017
von Spiczak J et al: Coronary artery stent imaging with CT using an integrated electronics detector and iterative reconstructions: first in vitro experience. J Cardiovasc Comput Tomogr. 7(4):215-22, 2013
Andreini D et al: Coronary in-stent restenosis: assessment with CT coronary angiography. Radiology. 265(2):410-7, 2012
Chung SH et al: Evaluation of coronary artery in-stent restenosis by 64-section computed tomography: factors affecting assessment and accurate diagnosis. J Thorac Imaging. 25(1):57-63, 2010
de Graaf FR et al: Diagnostic accuracy of 320-row multidetector computed tomography coronary angiography to noninvasively assess in-stent restenosis. Invest Radiol. 45(6):331-40, 2010
Sun Z et al: Diagnostic accuracy of 64 multislice CT angiography in the assessment of coronary in-stent restenosis: a meta-analysis. Eur J Radiol. 73(2):266-73, 2010
Serruys PW et al: A bioabsorbable everolimus-eluting coronary stent system (ABSORB): 2-year outcomes and results from multiple imaging methods. Lancet. 373(9667):897-910, 2009
Hoffmann R et al: Coronary in-stent restenosis - predictors, treatment and prevention. Eur Heart J. 21(21):1739-49, 2000
Mehran R et al: Angiographic patterns of in-stent restenosis: classification and implications for long-term outcome. Circulation. 100(18):1872-8, 1999
Hoffmann R et al: Patterns and mechanisms of in-stent restenosis. A serial intravascular ultrasound study. Circulation. 94(6):1247-54, 1996
Related Anatomy
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
TERMINOLOGY
Abbreviations
In-stent restenosis (ISR)
Definitions
Stenosis > 50% diameter reduction of coronary artery lumen inside or at edges of implanted stent
2 different morphologies
Focal ISR: Short stenosis anywhere within stent
Diffuse ISR: Stenosis along entire length of implanted stent
IMAGING
CT Findings
MR Findings
Echocardiographic Findings
Angiographic Findings
Nuclear Medicine Findings
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Dai T et al: Diagnostic performance of computed tomography angiography in the detection of coronary artery in-stent restenosis: evidence from an updated meta-analysis. Eur Radiol. 28(4):1373-82, 2018
Mannil M et al: Photon-Counting CT: High-Resolution Imaging of Coronary Stents. Invest Radiol. 53(3):143-9, 2018
Bangalore S et al: The state of the absorb bioresorbable scaffold: consensus from an expert panel. JACC Cardiovasc Interv. 10(23):2349-59, 2017
Hickethier T et al: Monoenergetic reconstructions for imaging of coronary artery stents using spectral detector CT: In-vitro experience and comparison to conventional images. J Cardiovasc Comput Tomogr. 11(1):33-9, 2017
von Spiczak J et al: Coronary artery stent imaging with CT using an integrated electronics detector and iterative reconstructions: first in vitro experience. J Cardiovasc Comput Tomogr. 7(4):215-22, 2013
Andreini D et al: Coronary in-stent restenosis: assessment with CT coronary angiography. Radiology. 265(2):410-7, 2012
Chung SH et al: Evaluation of coronary artery in-stent restenosis by 64-section computed tomography: factors affecting assessment and accurate diagnosis. J Thorac Imaging. 25(1):57-63, 2010
de Graaf FR et al: Diagnostic accuracy of 320-row multidetector computed tomography coronary angiography to noninvasively assess in-stent restenosis. Invest Radiol. 45(6):331-40, 2010
Sun Z et al: Diagnostic accuracy of 64 multislice CT angiography in the assessment of coronary in-stent restenosis: a meta-analysis. Eur J Radiol. 73(2):266-73, 2010
Serruys PW et al: A bioabsorbable everolimus-eluting coronary stent system (ABSORB): 2-year outcomes and results from multiple imaging methods. Lancet. 373(9667):897-910, 2009
Hoffmann R et al: Coronary in-stent restenosis - predictors, treatment and prevention. Eur Heart J. 21(21):1739-49, 2000
Mehran R et al: Angiographic patterns of in-stent restenosis: classification and implications for long-term outcome. Circulation. 100(18):1872-8, 1999
Hoffmann R et al: Patterns and mechanisms of in-stent restenosis. A serial intravascular ultrasound study. Circulation. 94(6):1247-54, 1996
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