Thallium-201 Exercise Scintigraphy After Percutaneous Transluminal Angioplasty of Coronary Artery Stenoses

Hirzel, H; K, Nüesch; Gruentzig, Andreas R.; Horst, W; Krayenbuehl, H. P.

doi:10.1016/s0025-7125(16)31613-3

Cited by 14 publications

(2 citation statements)

References 9 publications

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“…Angiography _ ff s_ _ .\immediately after the procedure confirmed that a * | i 11 k #i A.Lresidual narrowing of about 50 per cent was still present (Fig. 1B) dilatation, the isotope injections being made during stress ergometry and the redistribution imaged four hours later.7 8 Before dilatation there was a triangular, anteroseptal, scintigraphic defect which improved a few days later and was gone at the end of four months. The patient was free of symptoms and it was possible to discontinue all drug treatment.…”

Section: Resultsmentioning

confidence: 81%

Percutaneous transluminal dilatation of proximal stenosis of left anterior descending coronary artery in patient with bronchogenic carcinoma.

K¹,

Scholer²,

Pyle³

et al. 1981

Heart

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shadows were noted in the mid-zone of the right lung ( Fig. 2), each of which proved, upon needle biopsy, to be a small round cell anaplastic carcinoma. Although thc acute ischaemic episode appeared to have resolved, the patient continued to have severe angina despite treatment with propranolol (120 mg), and isosorbide dinitrate (60 mg), and this was the indication for an attempt at percutaneous transluminal coronary angioplasty. Method Under local anaesthesia, and by the Seldinger technique, a preshaped guiding cathetert was passed from the right femoral artery into the ascending aorta. Through this catheter a double-lumen dilatation catheter was guided into the ostium of the left coronary artery. At its tip the dilatation catheter has a distensible balloon segment of maximum diameter 3 mm. The balloon was introduced fully deflated into the left anterior descending artery, and positioned in the stenosis. It was then inflated with a mixture of 50 per cent contrast medium (76% Urografin) and saline, using an automatic calibrated pump. Three inflations were made using a pressure of 5 atmospheres to obtain maximum distension of the balloon in the stenosis without affecting the normal portion of the artery. Details of the method are described elsewhere.6 Dilatation was performed by AG. ResultsThe lumen of the left anterior descending artery

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Section: Resultsmentioning

confidence: 81%

Percutaneous transluminal dilatation of proximal stenosis of left anterior descending coronary artery in patient with bronchogenic carcinoma.

K¹,

Scholer²,

Pyle³

et al. 1981

Heart

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“…In most other reports on PTCA, noninvasive test results are not analyzed after the patients are subdivided into symptomatic and asymptomatic groups.8 [15][16][17][18] Clinical symptoms are very important in evaluating serial changes in the angiographic status of the patient, especially when evaluating the diagnostic usefulness of noninvasive test results.22 41 42 In our symptomatic patients, serial comparison of the noninvasive test results provided objective evidence of restenosis in 89% of the patients (eight of nine). The ninth patient had a 95% right coronary stenosis, large intercoronary collaterals, and a normal exercise ECG and thallium scintigram.…”

Section: Resultsmentioning

confidence: 99%

Exercise electrocardiography and myocardial scintigraphy in the serial evaluation of the results of percutaneous transluminal coronary angioplasty.

Scholl¹,

Chaitman²,

Planchard³

et al. 1982

Circulation

122

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SUMMARY The diagnostic value of exercise electrocardiography using 14 leads and thallium-201 scintigraphy were evaluated in 54 of 70 patients who underwent percutaneous transluminal coronary angioplasty (PTCA), both in the initial assessment and serial follow-up of patients after PTCA. Of the 45 patients who had successful PTCA, 36 had complete noninvasive studies performed before and 1 month after PTCA. Thirty-three of these 36 were asymptomatic 1 month after PTCA; the number of patients with an abnormal exercise ECG decreased from 20 to seven (p < 0.01) and with an abnormal thallium-201 scintigram from 21 to six (p < 0.001); the number of patients who had at least one of the two tests positive decreased from 26 to 10. The average treadmill time increased from 448 + 183 to 618 119 seconds (i < 0.001), and the average rate-pressure product increased from 19.81 ± 6.4 to 31.35 4.6 units x 10 (p < 0.001). Of the 10 patients with a positive test, two had a partial restenosis 50% but < 70% on the 6-month control angiogram; two had a residual stenosis ¢ 50% in a vessel that was not dilated and three had an abnormal scintigram before and 1 month after PTCA that subsequently became negative at 6 months. Six months after PTCA, a control angiogram was performed in 20 asymptomatic patients; 18 had an excellent PTCA result and two had a partial restenosis ¢ 50% but < 70%. The stress test results were normal in patients with a successful 6-month PTCA and abnormal in the two patients with a partial restenosis.Ten patients redeveloped angina within 3 months of PTCA; nine developed a restenosis ¢ 60% and one had a 90% left circumflex stenosis that could not be dilated or grafted. Six of the 10 patients had a normal exercise ECG and scintigram at 1 month that became abnormal when symptoms reappeared. The ratepressure product before PTCA and when angina symptoms recurred was similar (18.00 ± 2.20 vs 23.58 + units x 103) (NS).In conclusion, the use of clinical symptoms in conjunction with the physiologic data, ECG and myocardial scintigram acquired during exercise provide important short-term data on the angiographic evolution of PTCA results. The noninvasive tests may be useful in determining guidelines for repeat angiography in patients who have had PTCA.PERCUTANEOUS transluminal coronary angioplasty (PTCA) is a new technique that may be useful in the treatment of 5-10% of patients with coronary artery disease who are suitable candidates for coronary artery bypass grafting. 1-3However, the method is still considered an investigational procedure and many issues are not resolved.)7 Most reported series of PTCA are small and follow-up is short because the technique requires considerable expertise, is relatively new, and suitable patient recruitment is limited in most hemodynamic laboratories. The role of noninvasive diagnostic tests in the selection and serial follow-up of patients who are considered for PTCA is not well defined. In some reports, stress test results and radionuclide studies are not discussed, and in others the sequ...

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Sequential multivessel coronary angioplasty assessed by thallium‐201 tomography

DePuey

Roubin

DePasquale

et al. 1989

Cathet. Cardiovasc. Diagn.

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In 11 patients with multivessel coronary artery disease, SPECT thallium-201 imaging was performed prior to and within 3 days after each of two sequential percutaneous transluminal coronary angioplasties on separate days designed to achieve total revascularization. Thallium-201 SPECT was analyzed quantitatively, and an ischemic score for the vascular bed(s) supplied by the dilated vessel(s) was derived. For the vessels dilated during the first procedure the mean diameter stenosis was 80 +/- 8%, reduced to 27 +/- 9%. For the second procedure mean stenosis was reduced from 67 +/- 10% to 26 +/- 6%. For the two procedures, the mean thallium scores decreased from 298 +/- 225 to 115 +/- 130 (P less than .001) and from 135 +/- 129 to 46 +/- 60 (P less than .001), respectively. Of 10 patients with abnormal thallium-201 SPECT prior to angioplasty, nine improved after the first procedure, and seven improved further following the second procedure. Thus, utilizing staged angioplasty with a strategy of dilating the most severe lesion first, thallium-201 SPECT documented progressive improvement in myocardial perfusion.

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Thallium-201 Exercise Scintigraphy After Percutaneous Transluminal Angioplasty of Coronary Artery Stenoses

Cited by 14 publications

References 9 publications

Percutaneous transluminal dilatation of proximal stenosis of left anterior descending coronary artery in patient with bronchogenic carcinoma.

Percutaneous transluminal dilatation of proximal stenosis of left anterior descending coronary artery in patient with bronchogenic carcinoma.

Exercise electrocardiography and myocardial scintigraphy in the serial evaluation of the results of percutaneous transluminal coronary angioplasty.

Sequential multivessel coronary angioplasty assessed by thallium‐201 tomography

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