Selection of patients for preoperative coronary angiography: use of dipyridamole-stress--thallium myocardial imaging.
To identify patients likely to benefit from preoperative coronary angiography, a method utilizing pharmacologically induced coronary vasodilatation in conjunction with serial thallium 201 myocardial perfusion imaging was investigated. Fifty-four patients admitted for elective aortic or femoropopliteal procedures were studied. There were no cardiac ischemic complications in 32 patients with normal scans or persistent defects (scar). In contrast, 7 of 15 patients with thallium redistribution (ischemia) on pre-operative scanning had perioperative ischemic events, including one death and two acute infarcts. An additional seven patients with positive scans (redistribution) underwent coronary angiography prior to vascular surgery; surgically important two- or three-vessel disease was confirmed in all. Dipyridamole-thallium imaging facilitates selection of the subset of truly high-risk patients in whom preoperative coronary angiography may be warranted.
D000368:Aged; D001161:Arteriosclerosis / Q000601:surgery*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D004176:Dipyridamole / Q000008:administration & dosage*; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011868:Radioisotopes; D011877:Radionuclide Imaging; D013312:Stress, Physiological / Q000139:chemically induced*; D013793:Thallium
D011868:Radioisotopes; D004176:Dipyridamole; D013793:Thallium