TECHNETIUM-99M-SESTAMIBI SPECT TO DETECT RESTENOSIS AFTER SUCCESSFUL PERCUTANEOUS CORONARY ANGIOPLASTY

This study evaluated the accuracy of Tc-99m SPECT in predicting resten osis after primary successful PTCA. Methods: Thirty-seven patients wit h equivocal symptom-limited exercise stress testing were evaluated. Al l patients underwent separate day exercise-rest Tc-99m-sestamibi SPECT . The perfusion studies were evaluated using three different methods o f analysis: visual inspection, semiquantitative and quantitative polar map analysis. The perfusion studies were interpreted in absence of a pre-PTCA scan. All patients underwent a control coronary angiography w ithin 1 mo. Results: Sensitivity and specificity of Tc-99m-sestamibi S PECT in predicting restenosis were 87.5-78%, 50-65% and 75-74% for vis ual inspection, semiquantitative and quantitative polar map analysis, respectively. Sensitivity and specificity related to the vascular terr itories were: LAD territory 93-73% (qualitative analysis), 53-60% (sem iquantitative analysis), 80-67% (quantitative analysis); LCX territory 83-100% (qualitative analysis); and 33-100% (semiquantitative analysi s), 67-100% (quantitative analysis); and RCA territory 67-80% (qualita tive analysis), 67-60% (semiquantitative analysis), 67-80% (quantitati ve analysis). Conclusion: These data suggest that Tc-99m-sestamibi SPE CT is a useful noninvasive tool in the follow-up evaluation of patient s who have undergone angiographically successful coronary angioplasty even in the absence of a pre-PTCA perfusion study.