On conventional coronary CT, many stents cannot be assessed because of blooming from the metal struts, especially smaller stents. When the in-stent lumen cannot be seen, report it as nondiagnostic rather than implying patency. Reconstructing with a sharp kernel and viewing with wide window settings improves the chance of assessing the lumen.
- Reconstruct stents with a sharp kernel and review at wide window settings.
- Record the stent diameter where known; smaller stents are hardest.
- Write nondiagnostic when the lumen cannot be seen, not patent.
- Recommend functional or invasive assessment when the clinical question remains open.
Why it matters
A stent called patent on a scan that could not see inside it gives false reassurance.
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