Tc-99m Tetrofosmin Myocardial Perfusion Imaging Before and Six Months After Percutaneous Transluminal Coronary Angioplasty

Abstract

The role of Tc-99m tetrofosmin single-photon emission tomography (SPECT) in the evaluation of myocardial perfusion before and 6 months after successful percutaneous transluminal coronary angioplasty (PTCA) was assessed in 41 consecutive patients (32 men and 9 women). Twenty-five patients had one-vessel disease, 14 had two-vessel disease, and 2 had three-vessel disease. Thirty-six patients had dilation of one vessel and five patients dilation of two stenosed vessels, with a total of 46 dilated vessels. All patients underwent coronary angiography both before PTCA and 6 months after revascularization. Restenosis was angiographically demonstrated in 16 (39%) patients and 16 (34.8%) vessels. Tc-99m tetrofosmin myocardial SPECT was 81.3% sensitive and 88% specific for the detection of restenosis in the group of patients with a positive predictive value of 81.3% and a negative predictive value of 88%. Sensitivity, specificity, positive predictive value, and negative predictive value were 81.3%, 90%, 76.5%, and 89.7%, respectively, for restenosis detection in specific vessels. It was concluded that most patients who underwent successful PTCA (34 of 41, or 82.9%) had significant (P < 0.001) improvement in their scan image 6 months after the angioplasty, and that Tc-99m tetrofosmin myocardial SPECT is an excellent tool to follow these patients because it can detect restenosis accurately and noninvasively.

Koronate Mikroembolisierung — Bedeutung bei akuten koronaren Syndromen und bei interventionellen Eingriffen

“…Transient or permanent ST-segment changes ate observed [252]. Signs of ischemia in electrocardiography, echocardiography or scintigraphy may persist or disappear incompletely [18,67,85,142,252]. With close follow-up of cardiac enzymes after interventions, CK and CK-MB were elevated in 15 to 40% of patients [2,35,99,104,105,215].…”

Incremental prognostic value of 99mTc-tetrofosmin myocardial SPECT after percutaneous coronary intervention

“…Myocardial SPECT imaging is considered to be a reliable method for a realistic approach to myocardial perfusion, suitable for the evaluation of patients who have undergone PCI and the detection of restenosis [9][10][11][12][13][14][15][16][17]. Although the prognostic value of myocardial SPECT in patients with known or suspected CAD is well established, routine testing in patients after PCI is not generally recommended unless symptoms recur [9,10,21,22,24].…”

“…Myocardial perfusion single-photon emission computed tomography (SPECT) has been useful for the assessment of CAD and the identifi cation of critical stenoses before angioplasty, as well as the follow-up evaluation of patients after the intervention and the early detection of restenosis [10][11][12][13][14][15][16][17]. However, on the prognostic value of myocardial SPECT, limited data have been reported with the usual tracers ( 201 Tl, 99m Tc-MIBI) in patients after PCI, although there are currently scarce data to suggest the prognostic value of 99m Tc-tetrofosmin myocardial SPECT in patients after PCI [18][19][20][21][22][23][24][25][26].…”

Clinical Significance of Tetrofosm in Extracardiac Uptake During Myocardial Perfusion Imaging

“…Information gained from post-intervention myocardial SPECT is important to differentiate patients with angina from those with exo-cardiac chest pain syndromes, to assess peri-intervention myocardial damage/acute vessel closure, to predict-detect restenosis after PCI and graft occlusion/stenosis after CABG surgery, to detect CAD progression in non-revascularized vessels, to assess left ventricular function (gated-SPECT), to evaluate the effects of intervention if required for occupational reasons and to predict patients' long-term prognosis. With respect to detect graft patency, MPS has a 80-96% sensitivity and 61-88% specificity, while regarding restenosis after PCI, sensitivity and specificity range between 74-94% and 67-88%, respectively (Georgoulias et al, 1998(Georgoulias et al, , 2010b. Specifically, using Tc99m tetrofosmin as the radiotracer, we have reported a sensitivity, specificity, positive and negative predictive value of MPI in detecting restenosis of 81.3%, 88%, 81.3% and 88%, respectively, whereas for the detection of restenosis in specific vessel, the corresponding values were 81.3%, 90%, 76.5% and 89.7%, respectively (Georgoulias et al, 1998(Georgoulias et al, , 2010b.…”

“…With respect to detect graft patency, MPS has a 80-96% sensitivity and 61-88% specificity, while regarding restenosis after PCI, sensitivity and specificity range between 74-94% and 67-88%, respectively (Georgoulias et al, 1998(Georgoulias et al, , 2010b. Specifically, using Tc99m tetrofosmin as the radiotracer, we have reported a sensitivity, specificity, positive and negative predictive value of MPI in detecting restenosis of 81.3%, 88%, 81.3% and 88%, respectively, whereas for the detection of restenosis in specific vessel, the corresponding values were 81.3%, 90%, 76.5% and 89.7%, respectively (Georgoulias et al, 1998(Georgoulias et al, , 2010b.…”