Usefulness of semiquantitative analysis of dipyridamole-thallium-201 redistribution for improving risk stratification before vascular surgery

Journal Article · Wed Aug 15 00:00:00 EDT 1990 · American Journal of Cardiology; (USA)

DOI:https://doi.org/10.1016/0002-9149(90)90694-V· OSTI ID:6792765

Levinson, J R; Boucher, C A; Coley, C M; Guiney, T E; Strauss, H W; Eagle, K A ^[1]

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1. Harvard Univ. School of Medicine, Boston, MA (USA)

Preoperative dipyridamole-thallium-201 scanning is sensitive in identifying patients prone to ischemic cardiac complications after vascular surgery, but most patients with redistribution do not have an event after surgery. Therefore, its positive predictive value is limited. To determine which patients with thallium redistribution are at highest risk, dipyridamole-thallium-201 images were interpreted semiquantitatively. Sixty-two consecutive patients with redistribution on preoperative dipyridamole-thallium-201 planar imaging studies were identified. Each thallium scan was then analyzed independently by 2 observers for the number of myocardial segments out of 15, the number of thallium views out of 3 and the number of coronary artery territories with redistribution. Seventeen patients (27%) had postoperative ischemic events, including unstable angina pectoris, ischemic pulmonary edema, myocardial infarction and cardiac death. Thallium predictors of ischemic operative complications included thallium redistribution greater than or equal to 4 myocardial segments (p = 0.03), greater than or equal to 2 of the 3 planar views (p = 0.005) and greater than or equal to 2 coronary territories (p = 0.007). No patient with redistribution in only 1 view had an ischemic event (0 of 15). Thus, determining the extent of redistribution by dipyridamole-thallium-201 scanning improves risk stratification before vascular surgery. Patients with greater numbers of myocardial segments and greater numbers of coronary territories showing thallium-201 redistribution are at higher risk for ischemic cardiac complications. In contrast, when the extent of thallium redistribution is limited, there is a lower risk despite the presence of redistribution.

• OSTI ID: 6792765
• Journal Information: American Journal of Cardiology; (USA), Journal Name: American Journal of Cardiology; (USA) Vol. 66:4; ISSN 0002-9149; ISSN AJCDA
• Country of Publication: United States
• Language: English

Related Subjects

550600 -- Medicine
550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
BETA DECAY RADIOISOTOPES
BODY
CARDIOVASCULAR AGENTS
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
DRUGS
ELECTRON CAPTURE RADIOISOTOPES
HEART
HEAVY NUCLEI
ISCHEMIA
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MEDICINE
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PATIENTS
RADIOISOTOPE SCANNING
RADIOISOTOPES
RISK ASSESSMENT
SCINTISCANNING
SECONDS LIVING RADIOISOTOPES
SURGERY
THALLIUM 201
THALLIUM ISOTOPES
VASCULAR DISEASES
VASODILATORS