PREDICTION OF RESTENOSIS AFTER SUCCESSFUL PERCUTANEOUS CORONARY ANGIOPLASTY BY DOBUTAMINE TL-201 SCINTIGRAPHY

We evaluated the accuracy of dobutamine thallium-201 myocardial perfus ion scintigraphy in predicting restenosis after successful percutaneou s coronary angioplasty. Restenosis is one of the most important proble ms in patients who have undergone percutaneous coronary angioplasty. E xercise thallium-201 myocardial perfusion scintigraphy has been a well accepted non-invasive method to predict the restenosis of the dilated vessel after percutaneous coronary angioplasty, however, the role of thallium-201 myocardial perfusion using dobutamine, as a substitute fo r exercise in patients unable to exercise, in predicting restenosis is not well known. Therefore, 34 consecutive patients underwent dobutami ne tomographic (single photon emission computed tomography) thallium-2 01 myocardial perfusion scintigraphy following a total of 37 successfu l angioplasties. No serious side effects during dobutamine infusion oc cured. The interval between percutaneous coronary angioplasty and scin tigraphy ranged between 8 weeks to 2 years. All patients underwent con trol angiography within one month following myocardial perfusion scint igraphy. Sensitivity, specificity and accuracy of dobutamine myocardia l imaging for predicting restenosis were 76%, 79% and 77%, respectivel y. Sensitivity and specificity related to the vascular territories wer e: left anterior descending artery 66-69%, left circumflex artery 75-1 00%, right coronary artery 83-66%, respectively. In conclusion, our fi ndings demonstrating high accuracy of dobutamine myocardial single pho ton emission tomography for angiographic restenosis suggest its useful ness as a non-invasive tool in the follow-up of percutaneous coronary angioplasty patients. (C) 1998 Elsevier Science Ireland Ltd. All right s reserved.