Preoperative evaluation of cardiac risk using dobutamine-thallium imaging in vascular surgery

Journal Article · Tue May 01 04:00:00 EDT 1990 · Annals of Vascular Surgery; (USA)

DOI:https://doi.org/10.1007/BF02009451· OSTI ID:7015479

Zellner, J L; Elliott, B M; Robison, J G; Hendrix, G H; Spicer, K M ^[1]

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1. Medical Univ. of South Carolina, Charleston (USA)

Coronary artery disease is frequently present in patients undergoing evaluation for reconstructive peripheral vascular surgery. Dobutamine-thallium imaging has been shown to be a reliable and sensitive noninvasive method for the detection of significant coronary artery disease. Eighty-seven candidates for vascular reconstruction underwent dobutamine-thallium imaging. Forty-eight patients had an abnormal dobutamine-thallium scan. Twenty-two patients had infarct only, while 26 had reversible ischemia demonstrated on dobutamine-thallium imaging. Fourteen of 26 patients with reversible ischemia underwent cardiac catheterization and 11 showed significant coronary artery disease. Seven patients underwent preoperative coronary bypass grafting or angioplasty. There were no postoperative myocardial events in this group. Three patients were denied surgery on the basis of unreconstructible coronary artery disease, and one patient refused further intervention. Ten patients with reversible myocardial ischemia on dobutamine-thallium imaging underwent vascular surgical reconstruction without coronary revascularization and suffered a 40% incidence of postoperative myocardial ischemic events. Five patients were denied surgery because of presumed significant coronary artery disease on the basis of the dobutamine-thallium imaging and clinical evaluation alone. Thirty-nine patients with normal dobutamine-thallium scans underwent vascular reconstructive surgery with a 5% incidence of postoperative myocardial ischemia. Dobutamine-thallium imaging is a sensitive and reliable screening method which identifies those patients with coronary artery disease who are at high risk for perioperative myocardial ischemia following peripheral vascular surgery.

• OSTI ID: 7015479
• Journal Information: Annals of Vascular Surgery; (USA), Journal Name: Annals of Vascular Surgery; (USA) Vol. 4:3; ISSN 0890-5096; ISSN AVSUE
• Country of Publication: United States
• Language: English

Related Subjects

550600 -- Medicine
550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
ANIMALS
CARDIOVASCULAR DISEASES
COUNTING TECHNIQUES
DIAGNOSIS
DISEASES
ISOTOPES
MAMMALS
MAN
MEDICINE
PATIENTS
PRIMATES
RADIOISOTOPE SCANNING
RISK ASSESSMENT
SENSITIVITY ANALYSIS
SURGERY
THALLIUM ISOTOPES
VASCULAR DISEASES
VERTEBRATES