Clinical significance of perfusion defects by thallium-201 single photon emission tomography following oral dipyridamole early after coronary angioplasty

Journal Article · Sun May 01 00:00:00 EDT 1988 · J. Am. Coll. Cardiol.; (United States)

DOI:https://doi.org/10.1016/S0735-1097(98)90053-5· OSTI ID:6994089

Jain, A; Mahmarian, J J; Borges-Neto, S; Johnston, D L; Cashion, W R; Lewis, J M; Raizner, A E; Verani, M S

The clinical significance of myocardial perfusion defects present early after angiographically successful percutaneous transluminal coronary angioplasty was assessed in 53 patients using thallium-201 single photon emission computed tomography combined with pharmacologic vasodilation induced by a large dose (300 mg) of orally administered dipyridamole. Myocardial tomographic images were obtained at a mean of 20 +/- 6 h (SD) before and 2.9 +/- 2.7 days after angioplasty. Before angioplasty, 15 (28%) of the 53 patients developed angina after dipyridamole administration, in contrast to only 3 (7.5%) of 40 patients after angioplasty (p less than 0.001). The mean percent luminal area stenosis decreased from 93 +/- 6% before angioplasty to 34 +/- 17% after angioplasty (p less than 0.001). Myocardial perfusion defects, present in 49 (93%) of the 53 patients before angioplasty, were reversible in 44 patients (83%), all of whom underwent dilation of arteries supplying the ischemic areas. After angioplasty, 26 (65%) of 40 patients had no ischemic defects, whereas 14 (35%) of the patients still had an ischemic defect in the vascular territory of the dilated artery. After a mean follow-up period of 21.7 months, 13 (33%) of 39 patients developed restenosis, 10 of whom had an ischemic defect early after angioplasty. Restenosis developed in 10 (71%) of 14 patients with an ischemic defect after angioplasty, but in only 3 (11.5%) of the patients without an ischemic defect (p = 0.007). In conclusion, thallium-201 tomography after oral dipyridamole affords convenient assessment of the physiologic significance of coronary stenosis present before angioplasty and the residual stenosis after angioplasty.

• Research Organization: Baylor College of Medicine, Houston, TX (USA)
• OSTI ID: 6994089
• Journal Information: J. Am. Coll. Cardiol.; (United States), Journal Name: J. Am. Coll. Cardiol.; (United States) Vol. 11:5; ISSN JACCD
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
BETA DECAY RADIOISOTOPES
BODY
CARDIOVASCULAR AGENTS
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
COMPUTERIZED TOMOGRAPHY
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
DRUGS
ELECTRON CAPTURE RADIOISOTOPES
EMISSION COMPUTED TOMOGRAPHY
HEART
HEAVY NUCLEI
ISCHEMIA
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MEDICINE
MUSCLES
MYOCARDIUM
NUCLEI
ODD-EVEN NUCLEI
ORAL ADMINISTRATION
ORGANS
PATIENTS
PERFUSED ORGANS
RADIOISOTOPES
SECONDS LIVING RADIOISOTOPES
SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY
SURGERY
THALLIUM 201
THALLIUM ISOTOPES
TOMOGRAPHY
VASCULAR DISEASES
VASODILATION
VASODILATORS