REDISTRIBUTION IN TL-201 MYOCARDIAL IMAGING SOON AFTER SUCCESSFUL CORONARY STENTING - TOMOGRAPHIC EVALUATION DURING CORONARY HYPEREMIA INDUCED BY ADENOSINE

To evaluate the clinical significance of reversible perfusion defects that were observed soon after the successful deployment of a coronary stent, 47 patients underwent thallium-201 myocardial scintigraphy and radionuclide angiography in conjunction with adenosine-induced coronar y hyperemia before: and after complete revascularization. Coronary ang iography showed a significant decrease in the percent diameter stenosi s (from 87+/-11% before stenting to -1+/-5% after stenting, p<0.01) wi th no major dissection, residual stenosis, or intra-stent formation of thrombus, Even after the angiographically successful procedure, rever sible perfusion defects were present in 17 (36%) of the 47 patients, n one of whom showed any wall motion abnormalities during the infusion o f adenosine, Disease duration was significantly longer and collateral vessels were more common in the patients with than in those without th allium redistribution, whereas the other clinical, pre-and post-stent angiographic and hemodynamic factors were similar. In conclusion, reve rsible perfusion defects without wall motion abnormalities were demons trated during the infusion of adenosine in approximately one-third of patients soon after coronary stenting, and were not consistently relat ed to acute unfavorable outcomes of stent placement.