Non-invasive diagnosis of in stent stenosis by stress 99m technetium tetrofosmin myocardial perfusion imaging.

Abstract

BACKGROUND:

The aim of this study was to assess the accuracy of stress 99m technetium tetrofosmin myocardial perfusion imaging for the diagnosis of in stent stenosis (ISS).

METHODS:

We studied 72 patients who underwent exercise or dobutamine stress 99m technetium tetrofosmin imaging, 0.9+/-0.5 years after percutaneous coronary interventions in which stents were deployed. Coronary angiography was performed within 3 months of the stress test. ISS was defined as > or =50% stenosis in a coronary segment with previous stenting. Significant coronary artery disease (CAD) was defined as > or =50% stenosis within or outside the stented coronary segment.

RESULTS:

The stent was deployed in 1 coronary artery in 52 patients, and in 2 coronary arteries in 20 patients (a total of 92 detected in 42 (58%) patients (51 stents). Reversible perfusion abnormalities were present in 34 of patients with ISS (sensitivity=81%, CI 70-94). Regional sensitivity for diagnosis of stenosis per stent was 76% (CI 65-88), specificity was 83% (CI 71-94) and accuracy was 79% (CI 69-85). Reversible perfusion abnormalities were detected in > or =2 vascular distributions in 15 of 22 patients with multi-vessel CAD and in 5 of 50 patients without (sensitivity for identifying multivessel CAD=68%, CI 50-89; specificity=90%, CI 82-98; and accuracy=83%, CI 75-90).

CONCLUSION:

Stress 99m technetium tetrofosmin myocardial perfusion imaging is a useful non-invasive technique for the diagnosis of in stent stenosis and extent of CAD in patients with previous percutaneous coronary artery interventions.

• Authors: Abdou Elhendy, Arend F L Schinkel, Ron T van Domberg, Jeroen J Bax, Roelf Valkema, Don Poldermans
• Journal: The international journal of cardiovascular imaging (Int J Cardiovasc Imaging) Vol. 22 Issue 5 Pg. 657-62 (Oct 2006) ISSN: 1569-5794 [Print] United States
• PMID: 16628382 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Adrenergic beta-Agonists
• Organophosphorus Compounds
• Organotechnetium Compounds
• Radiopharmaceuticals
• Dobutamine
• technetium tc-99m tetrofosmin

Topics

• Adrenergic beta-Agonists
• Angioplasty, Balloon, Coronary
• Coronary Angiography
• Coronary Artery Disease (diagnostic imaging)
• Coronary Circulation
• Coronary Restenosis (complications, diagnosis, diagnostic imaging)
• Dobutamine
• Exercise Test
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Myocardial Ischemia (diagnostic imaging, etiology, physiopathology)
• Organophosphorus Compounds
• Organotechnetium Compounds
• Predictive Value of Tests
• Radiopharmaceuticals
• Research Design
• Sensitivity and Specificity
• Stents
• Time Factors
• Tomography, Emission-Computed, Single-Photon (methods)