Coronary bifurcation stent morphology in dual-source CT: validation with micro-CT

The aim of this study is to analyze post-bifurcation coronary stent morphology in vitro using dual-source CT and validate those findings using micro-CT. Nine silicon coronary artery phantoms simulating main branch (MB) and side branch (SB) were prepared using a 3-D printer. After bifurcation stenting using Crush, Culotte, and T-stenting technique, in vitro CT imaging was conducted using both dual-source CT and micro-CT. Morphological change of the bifurcation stent including crushed segment and floating stent strut were evaluated. Dual-source CT was able to demonstrate morphologic changes of bifurcation stents and was comparable to micro-CT. In stents with Crush and T-stenting methods, crushed segment appeared denser and thicker than other stent parts and was located at MB side in all phantoms. Floating strut was observed in half of the phantoms with Crush technique and all phantoms with T-stenting. Parameters measured in both dual-source CT and micro-CT showed good correlation and high agreement (limits of agreement and correlation for length, perimeter and area, 0.3 ± 3.5, 0.5 ± 2.1 mm, and 0.0 ± 1.5 mm², r = 0.76, 0.92, and 0.91). The morphology of post-bifurcation stent on dual-source CT correlates well with that of micro-CT in the coronary artery phantom. Coronary CT angiography may be a feasible method for the evaluation of stent morphology in patients who underwent bifurcation stenting.