KẾT QUẢ BƯỚC ĐẦU TRONG ĐÁNH GIÁ TÌNH TRẠNG TÁI HẸP SAU ĐẶT STENT MẠCH VÀNH TRÊN MÁY CHỤP CẮT LỚP VI TÍNH LƯỢNG TỬ TẠI BỆNH VIỆN BẠCH MAI

Abstract

Coronary artery stenting is an effective and widely used interventional procedure that rapidly restores myocardial perfusion. However, diagnosing and detecting in-stent restenosis early remains a significant challenge. The advent of photon-counting detector computed tomography (PCD-CT) represents an important advancement in cardiovascular imaging. This technology provides substantially higher spatial resolution, reduced noise, and fewer metal artifacts—particularly in small-diameter stents, overlapping stents, or heavily calcified coronary arteries—compared with conventional CT systems. These characteristics allow more reliable direct visualization of the stent lumen and adjacent vessel wall. Consequently, PCD-CT has the potential to become an optimal non-invasive imaging tool for the follow-up of patients after coronary stent implantation. At the Institute of Diagnostic and Interventional Radiology, Bach Mai Hospital, a photon-counting CT system has been implemented since December 2025. During the first month of clinical use, this technique was applied to nine patients with a history of coronary stent implantation who were referred for CT evaluation due to suspected in-stent restenosis or routine follow-up; two of these patients also underwent invasive coronary angiography (DSA) for comparison. This case series aims to present our initial experience regarding the value of PCD-CT in the assessment of in-stent restenosis, highlighting its superior image quality and reliable non-invasive evaluation capability, and demonstrating the potential for broader clinical application of this technology in cardiovascular practice in Vietnam.