Important role of cardiac spect imaging in patients undergoing percutaneous transluminal coronary angioplasty

Objective To examine the utilization and contribution of cardiac perfusion scans to patients undergoing percutaneous transluminal coronary angioplasty . Methods From July 1996 to January 1998, 34 patients underwent percutaneous transluminal coronary angioplasty and cardiac SPECT imaging was studied. Tw enty-five patients had pre-procedure SPECT scans. The agreement between ang ioplasty strategies and SPECT findings of ischemia and hypokinesia was exam ined. Results When radionuclide imaging was performed before revascularization pr ocedures, 84% of the patients had intervention strategies guided by scan fi ndings. Perfusion scan findings including extent and severity of ischemia, degree of hypokinesia directed the selection of target vessel for angioplas ty in the patient subgroup with mutti-vessel disease. Postangioplasty radio nuclide cardiac scans were performed only on symptomatic patients, demonstr ating ischemia and hypokinesia in most of them, conceivably reflected the s election bias. Conclusion We recommend routine pre- and postangioplasty radionuclide imagi ng with multigated scans for wall motion assessment for all patients receiv ing coronary intenvention.