Detection of Restenosis After Percutaneous Translu minal Coronary Angioplasty Using the Exercise Treadmill Test and Technetium 99m-Sestamibi Scinti graphy
SUPHOT SRIMAHACHOTA, M.D.*, TODSAPOL LIMPUANKIT, M.D.*, SMONPORN BOONYARATAVEJ, M.D.*, SUPATTARAPORN TEPMONGKOL, M.D.**, WASAN UDAYACHALERM, M.D.*, TAWORN SUITHICHAIYAKUL, M.D.*, PEUNGCHAI NGARMUKOS, M.D.*
Affiliation : * Cardiac Center and Division of Cardiovascular Diseases, Department of Medicine, ** Radionuclide Unit, Department of Radiology, King Chulalongkom Memorial Hospital, Bangkok 10330, Thailand.
Method : Tc-99m MIBI with SPECT imaging was performed at months 1, 3 and 6 and CAG was repeated 6 months after successful PTCA. Earlier Tc-99m MIBI and CAG were performed in patients with recurrent angina pectoris or suspected restenosis.
Results : Forty six patients (M 29, F 17) who had undergone successful angioplasty were prospectively enrolled. Their mean age was 61 ± 19 yrs. Eighty eight lesions (LAD63%, LCX34%, RCA19%) were performed. Lesion characteristics were type A in 9 per cent, type in B 30 per cent and type C in 61 per cent. Fifty four per cent of PTCA were performed for single vessel disease and 46 per cent for multivessel disease. The mean duration of time between PTCA and follow-up CAG was 6.1 ± 2.7 months. We detected restenosis from CAG in 58 per cent of the cases. The Tc-99m MIBI had higher sensitivity to detect restenosis than anginal pain (85.0% vs 39.4% p < 0.005) or EST (85.0% vs 63.6% p < 0.05) when compared with CAG. The overall accuracy of Tc-99m MIBI for the detection of restenosis was 80 per cent. C~nclusion : Tc-99m MIBI with SPECT imaging constitutes a better means than symptoms or exercise test to detect restenosis after successful coronary angioplasty.
Keywords : Technetium-99m Sestamibi, Coronary Angioplasty, Restenosis
