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Abstract
The role of tomographic thallium-201 exercise and redistribution imaging in the detection
of restenosis after percutaneous transluminal coronary angioplasty (PTCA) was evaluated
in 116 patients: 61 (53%) with 1- and 55 (47%) with multivessel PTCA, with a total
of 185 dilated vessels. Complete revascularization was performed in 89 (77%) and partial
revascularization in 27 (23%) of the patients. Restenosis was angiographically demonstrated
in 69 (60%) of the patients and 85 (46%) of the vessels 6.4 ± 3.1 months after PTCA.
Disease progression in previously normal vessels was noted in 11 patients. The results
were: (1) for detection of restenosis in the group of patients, single-photon emission
computed tomographic (SPECT) versus exercise electrocardiographic sensitivity was
93 vs 52% (p < 0.001), specificity 77 vs 64%, and accuracy 86 vs 57% (p < 0.001).
The results were similar in the complete and partial revascularization groups. (2)
SPECT was 86% sensitive, specific and accurate for restenosis detection in specific
vessels with comparable results for 1-versus multivessel PTCA and complete versus
partial revascularization. Sensitivity, specificity and accuracy were: 89, 95 and
92% for the left anterior descending coronary artery; 88, 79 and 82% for the right
coronary artery; and 76, 83 and 85% for the left circumflex coronary artery. Eighty-one
percent of the diseased nondilated vessels were correctly identified. (3) Disease
progression to >50% stenosis was detected with 91% sensitivity, 84% specificity and
85% accuracy. SPECT thallium-201 imaging is an excellent tool for the detection of
restenosis and disease progression after PTCA in the settings of 1- and multivessel
angioplasty and complete and partial revascularization.
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Article Info
Publication History
Accepted:
July 16,
1990
Received:
May 15,
1990
Identification
Copyright
© 1990 Published by Elsevier Inc.
