Determination of Cardiac Risk by Dipyridamole-Thallium Imaging Before Peripheral Vascular Surgery

Boucher, Charles A.; Webster, D C; Darling, R. Clement; Okada, Robert D.; Strausś, H. William; Pohost, Gerald M.

doi:10.1097/00132586-198510000-00036

Cited by 22 publications

(26 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Dipyridamole-thallium stress testing is now widely used for the preoperative evaluation of the cardiac risk associated with major vascular surgery (Boucher et al 1985;Leppo et al 1987;Eagle et al 1989). Operative risk is also determined by other factors including left ventricular function (Goldman et al 1977), and under many circumstances evaluation of the left ventricular systolic function by radionuclide ventriculography is also deemed necessary before surgery.…”

Section: Introductionmentioning

confidence: 99%

Efficiency of labelling of red blood cells with technetium-99m after dipyridamole infusion for thallium-201 stress testing

Hicks

Arkles

1992

Eur J Nucl Med

View full text Add to dashboard Cite

Experimental studies have suggested that dipyridamole may inhibit red blood cell labelling with technetium-99m. To evaluate whether this effect is clinically relevant to the performance of radionuclide ventriculography after dipyridamole-thallium stress testing, in vitro red blood cell labelling was compared immediately before and after thallium-201 stress scintigraphy combined with either dipyridamole infusion (30 patients) or exercise stress (20 patients). Modified in vivo red blood cell labelling efficiency was assessed in a further 36 patients following dipyridamole infusion and was compared with that in 15 patients following exercise stress. The importance of a reversal of the dipyridamole effects by aminophylline was evaluated for in vitro and modified in vivo techniques. The red blood cell labelling efficiency was not significantly different in patients following dipyridamole compared with that obtained following exercise stress for both in vitro (93% +/- 4% versus 91% +/- 4%) and modified in vivo (87% +/- 19% versus 90% +/- 6%) techniques. Also, in vitro red blood cell labelling efficiency after dipyridamole was not different to that before stress testing (93% +/- 4% versus 92% +/- 4%). Reversal with aminophylline had no significant effect on the in vitro labelling efficiency with either the in vitro technique (94% +/- 3% with reversal versus 92% +/- 5% without) or the modified in vivo technique (91% +/- 4% with reversal versus 82% +/- 26% without). These results suggest that the red blood cell labelling efficiency is not compromised by the preceding dipyridamole-thallium stress testing but can be optimised by using in vitro labelling.

show abstract

Section: Introductionmentioning

confidence: 99%

Efficiency of labelling of red blood cells with technetium-99m after dipyridamole infusion for thallium-201 stress testing

Hicks

Arkles

1992

Eur J Nucl Med

View full text Add to dashboard Cite

show abstract

“…According to findings from a number of studies, dipyridamole-thallium scanning (DTS) is now the most widely used method for determination of cardiac risk. The accuracy of DTS for evaluation of cardiac risk was first demonstrated by Boucher et al 21 in 54 patients indicated for vascular reconstuction and not eligible for ET and was confirmed by subsequent studies. 22 According to Eagle et al, 23 a combination of simplified clinical data and DTS optimizes preoperative evaluation of cardiac risk and reduces the need for coronary arteriography.…”

Section: Discussionmentioning

confidence: 76%

“…22 According to Eagle et al, 23 a combination of simplified clinical data and DTS optimizes preoperative evaluation of cardiac risk and reduces the need for coronary arteriography. The sensitivity of DTS is excellent (75% to 100% 21,[24][25][26] ) and its specificity is less good (55% to 72% 24-26 ) but can be enhanced by combination with other noninvasive methods. 6,16 However, in a prospective study by Baron et al,27 cardiac events were observed in over 20% of 457 patients evaluated with DST before aortic reconstruction and statistical study showed no correlation between these events and DST data, the only relevant factors being age and history of coronary events.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Cardiac Risk Before Aortic Reconstruction: Noninvasive Work-Up Using Clinical Examination, Exercise Testing, and Dobutamine Stress Echocardiography Versus Routine Coronary Arteriography

Therre

Ribal

Motreff

et al. 1999

Annals of Vascular Surgery

View full text Add to dashboard Cite

“…Boucher et al [7] were the first to show that dipyridamole-thallium studies are predictive of subsequent cardiac events in patients with vascular disease. Eagle et al [8] showed that based on clinical assessment of certain cardiac risk factors, those patients with high risk of coronary artery disease, or those with a very low risk of coronary artery disease did not require perfusion studies for risk stratification.…”

Section: Discussionmentioning

confidence: 99%

Value of absence of a transient myocardial perfusion defect during stress myocardial perfusion study in patients undergoing major vascular surgery

Golzar

Movahed

2005

Int J Cardiovasc Imaging

View full text Add to dashboard Cite

Pre-operative cardiac assessment is important in the evaluation of patients undergoing major vascular surgery. Our study aims to evaluate the value of absence of a transient myocardial perfusion defect during radionuclide myocardial perfusion study for prediction of cardiac events (myocardial infarction, sudden cardiac death, unstable angina, coronary artery revascularization and congestive heart failure) in patients undergoing major vascular surgery. We studied 63 consecutive patients (ages 35-83 [avg. 64], male 39, female 24) with radiographically proven, abdominal aortic aneurysm or severe aortofemoral occlusive disease who underwent major vascular surgery (abdominal aortic aneurysm repair [38] or aortofemoral bypass [25]). The subjects all had multiple coronary artery risk factors (hypertension 48, diabetes 10, hyperlipidemia 23, tobacco use 39, family history of coronary artery disease 10), but a negative pre-operative stress myocardial perfusion study for myocardial ischemia. Of these 63 patients, 17 patients were able to exercise and achieve their adequate 85% maximal predicted heart rate. Thirty-eight patients received adenosine infusion of 140 microg/kg/min for 6 min. Six patients received dipyridamole infusion of 0.56 mg/kg over 4 min. Two patients received dobutamine infusion at 5, 10, 20, 30, and 40 mg/kg/min. Of the 63 patients, 60 received 3-4 mCi of thallium-201 ((201)Tl) and 3 patients received 8-9 mCi of technetium-99m (99mTc) at rest and 25-30 mCi 99mTc during stress. The subjects all underwent major vascular surgery and were followed up to one year for any cardiac events. Of the 63, who underwent pre-operative cardiac assessment with myocardial perfusion testing, 25 had a fixed myocardial perfusion defect (scar) and none had evidence of transient myocardial perfusion defect (ischemia). One subject had coronary artery bypass grafting 11 months after aortofemoral bypass surgery. One died from a stroke one month after aortofemoral bypass surgery. Of the remaining 61 patients, none had any cardiac events up to one year after major vascular surgery.

show abstract

Determination of Cardiac Risk by Dipyridamole-Thallium Imaging Before Peripheral Vascular Surgery

Cited by 22 publications

References 0 publications

Efficiency of labelling of red blood cells with technetium-99m after dipyridamole infusion for thallium-201 stress testing

Efficiency of labelling of red blood cells with technetium-99m after dipyridamole infusion for thallium-201 stress testing

Assessment of Cardiac Risk Before Aortic Reconstruction: Noninvasive Work-Up Using Clinical Examination, Exercise Testing, and Dobutamine Stress Echocardiography Versus Routine Coronary Arteriography

Value of absence of a transient myocardial perfusion defect during stress myocardial perfusion study in patients undergoing major vascular surgery

Contact Info

Product

Resources

About