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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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References
- Multiple vessel coronary angioplasty: classification, results and patterns of restenosis in 494 consecutive patients.Cathet Cardiovasc Diagn. 1987; 13: 1-15
- Coronary angioplasty: a therapeutic option for symptomatic patients with two and three vessel coronary disease.J Am Coll Cardiol. 1988; 11: 1173-1179
- Risk factors, time course and treatment for restenosis after successful coronary angioplasty of chronic total occlusions.Am J Cardiol. 1989; 63: 877-901
- Unstable angina and coronary angioplasty.Circulation. 1990; 82: II-88-II-95
- Restenosis after percutaneous transluminal coronary angioplasty (PTCA): a report from the PTCA registry of the National Heart, Lung, and Blood Institute.Am J Cardiol. 1984; 53: 77C-81C
- Clinical and angiographic assessment six months after double vessel percutaneous coronary angioplasty.J Am Coll Cardiol. 1985; 6: 1239-1244
- Recurrence after successful coronary angioplasty.Eur Heart J. 1985; 6: 276-281
- Restenosis after successful coronary angioplasty in patients with single vessel disease.Circulation. 1986; 73: 710-717
- Incomplete revascularization in multivessel percutaneous transluminal coronary angioplasty: the role for stress thallium-201 imaging.J Am Coll Cardiol. 1988; 11: 1183-1190
- Incomplete revascularization and complex lesion morphology: relationship to early and late results in multivessel coronary angioplasty.J Invas Cardiol. 1990; 2: 93-101
- Exercise stress testing in evaluation of patients with ischemic heart disease.Prog Cardiovasc Dis. 1979; 11: 371-390
- Silent ischemia: evaluation byexercise and redistribution tomographic thallium-201 myocardial imaging.J Am Coll Cardiol. 1989; 14: 895-900
- Quantification of rotational thallium-201 myocardial tomography.J Nucl Med. 1985; 26: 17-26
- Detection of restenosis after elective percutaneous transluminal coronary angioplasty using the exercise treadmill test.Am J Cardiol. 1990; 65: 28-34
- Exercise treadmill testing is a poor predictor of anatomic restenosis after angioplasty for acute myocardial infarction.Circulation. 1989; 80: 1585-1594
- Early detection of restenosis after successful percutaneous transluminal coronary angioplasty by exercise-redistribution thallium scintigraphy.Am J Cardiol. 1985; 55: 357-361
- Quantitative exercise thallium-201 scintigraphy for predicting angina recurrence after percutaneous transluminal coronary angioplasty.Am J Cardiol. 1989; 63: 517-521
- Restenosis after transluminal coronary angioplasty detected with exercise-gated radionuclide ventriculography.J Am Coll Cardiol. 1984; 4: 1103-1113
- Quantitative rotational thallium-201 tomography for identifying and localizing coronary artery disease.Circulation. 1988; 77: 316-327
- Quantitative single photon emission computed thallium-201 tomography for detection and localization of coronary artery disease: optimization and prospective validation of a new technique.J Am Coll Cardiol. 1989; 14: 1689-1699
- Quantitative exercise thallium-201 single photon emission computed tomography for the enhanced diagnosis of ischemic heart disease.J Am Coll Cardiol. 1990; 15: 318-329
- Recurrent ischemia more than 1 year after successful percutaneous transluminal coronary angioplasty. An analysis of the extent and anatomic pattern of coronary disease.Circulation. 1989; 80: 1580-1584
- Does percutaneous transluminal coronary angioplasty accelerate atherosclerotic lesions.Cathet Cardiovasc Diagn. 1990; (in press)
- Analysis and probability as an aid in the clinical diagnosis of coronary artery disease.N Engl J Med. 1979; 300: 1350-1358
Article Info
Publication History
Accepted:
July 16,
1990
Received:
May 15,
1990
Identification
Copyright
© 1990 Published by Elsevier Inc.