ACCURACY OF SINGLE-PHOTON EMISSION COMPUTED-TOMOGRAPHY MYOCARDIAL PERFUSION IMAGING IN PATIENTS WITH STENTS IN NATIVE CORONARY-ARTERIES

Strategies to noninvasively evaluate patients after coronary stenting have not been evaluated. To determine the accuracy of single-photon em ission computed tomography (SPECT) myocardial perfusion imaging in pat ients after coronary stenting, 209 patients, who had undergone stentin g followed by late stress SPECT myocardial perfusion imaging were eval uated. Quantitative coronary angiography was performed in 33 patients following SPECT imaging. SPECT restenosis was defined as a reversible or fixed defect within the stented vascular territory. Angiographic re stenosis was examined using 2 definitions: total area narrowing greate r than or equal to 50% or greater than or equal to 70% of the stent si te or stented artery. The SPECT and angiographic findings were concord ant in 22 of 33 stented vascular territories using the 50% definition of restenosis and in 29 of 33 stented territories using the 70% defini tion. Use of the 70% definition of restenosis resulted in improved acc uracy of SPECT to detect a significant stenosis in the stented artery. Sensitivity, specificity, positive predictive valve, negative predict ive value, and accuracy of SPECT were 95%, 73%, 88%, 89%, and 88% resp ectively. In patients with positive SPECT scans, the most significant stenosis in the stented artery was outside the stent site in 50% of ca ses. SPECT imaging appears to be accurate to predict significant steno sis in the stented artery, although the most severe stenosis is freque ntly distant from the stent site. (C)1998 by Excerpta Medica, Inc.