Noninvasive coronary computed tomography analysis after bioresorbable scaffold implantation

Noninvasive coronary computed tomography angiography has shown to be an accurate method for the exclusion of significant coronary artery stenosis, with negative predictive values. The bioresorbable vascular scaffold has a translucent polymeric backbone that allows for noninvasive coronary computed tomography angiography (CTA). The recommendations for image acquisition for scaffold evaluation are similar to the recommendations for native coronary vessels. The assessment of the images should focus on the treated segment. Scrolling of transaxial images allows displaying the course of the treated vessel and assists identifying the radio-opaque markers located at each edge of the scaffold. Luminal and vessel segmentation is visually assessed in the multi-planar reformation (MPR) images. After coronary lumen segmentation, three-dimensional (3-D) vessel reconstruction is performed. The 3-D geometry could be further processed using computational fluid dynamic and the finite element method to evaluate physiologic parameters such as fractional flow reserve and shear stress in a patient-specific model.