Author + information
- Basil (Vasilios) Thanopoulos, MD, PhD⁎ ( )(, )
- Nicholaos Eleftherakis, MD,
- Konstadinos Tzanos, MD,
- Ioannis Skoularigis, MD and
- Fillipos Triposkiadis, MD
- ↵⁎Department of Pediatric Cardiology, “Aghia Sophia” Children's Hospital, Thivon and Levadias Street, Athens 115 27, Greece
We fully agree with the comments of Dr. Kenny and colleagues. Multislice computed tomography (MSCT) is currently the noninvasive imaging modality of choice for the evaluation of patients with coarctation of the aorta (CoA) after stent implantation. Indeed, this technique provides detailed 3-dimensional anatomic images not only of the aorta but also of the coronary arteries, which is of great importance for adult patients with CoA. In addition, accurate measurements of the aortic diameters at the stented segment can be obtained with this imaging modality. A major limitation of this technique is the significant radiation exposure—which, however, will be lowered in the not-so-far future with the newer 256 MSCT devices.
Magnetic resonance imaging (MRI) is of limited value in CoA after stent implantation, because the stent-related “shielding” artifacts prevent detailed evaluation of the aorta within the stented aortic area. In our study (1), MRI angiography was used for patient evaluation before the intervention and at follow-up for the evaluation of the intervention result when MSCT was not available and also for the assessment of the brain circulation (circle of Willis). We currently use MSCT to identify stent fractures and in-stent restenosis and to evaluate the effects of intervention on aortic wall at 1 month and 2 and 5 years after stent implantation for adult CoA.
- American College of Cardiology Foundation