[Detection of coronary restenosis using myocardial tomoscintigraphy with thallium 201. A series of 85 cases].
After a successful coronary angioplasty (less than 50 p. 100 residual stenosis and no complication), can restenosis be detected by a non-invasive method? We tested the value of stress thallium 201 myocardial scintigraphy by comparing this method with clinical angina and the conventional exercise-induced angina test. The study was prospective and involved 85 patients (74 men, 11 women; mean age 54.7 years, range 33-78 years). Sixty patients were suffering from angina, 13 had post-infarction angina and 12 had mild necrosis. Angioplasty had been performed on a single vessel (LAD in 57 cases, right in 18 cases and CX in 10 cases). After 6.4 +/- 1.8 months, all patients were re-evaluated under treatment, undergoing successively an exercise test, a stress and recovery myocardial scintigraphy and a coronary angiography. Restenosis was defined as a more than 50 p. 100 reduction of diameter on two orthogonal planes and was observed in 22 cases (26 p. 100). 19 patients were suffering from angina, 12 had restenosis, 10 were asymptomatic but had restenosis. Eighteen exercise tests were pathological; 10 corresponded to restenosis and 12 were normal in spite of restenosis. Myocardial scintigraphy was regarded as positive when, outside a necrotic territory, a lack of uptake at stress was reversible or became worse at redistribution. 27 tests were positive, 18 corresponded to restenosis, 4 were normal in spite of restenosis. The diagnostic values of the three methods were compared: (Table: see text).


CONCLUSIONS
(1) stress myocardial scintigraphy has the best sensitivity and specificity; (2) if it is negative, restenosis is very unlikely; (3) coronary angiography may be performed only in case of symptoms and/or of positive stress scintigraphy.
Lusson
J R
JR
Cardiologie, hôpital Saint-Jacques, Clermont-Ferrand.
Citron
B
B
Peycelon
P
P
Maublant
J
J
Kohler
P
P
Richard
A
A
Ponsonnaille
J
J
Cassagnes
J
J
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000628:therapy; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000628:therapy; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence; D013794:Thallium Radioisotopes; D014055:Tomography, Emission-Computed
D013794:Thallium Radioisotopes
Détection de la resténose coronarienne par la tomoscintigraphie myocardique au thallium 201. Série de 85 observations.