Myocardial perfusion imaging after transient balloon occlusion during percutaneous coronary interventions.
BACKGROUND
Myocardial perfusion imaging (MPI) is highly sensitive in detecting rest ischemia when the radiotracer is injected during the episode of ischemia. The frequency of abnormal MPI results after resolution of ischemia is not well defined. The aim of this study was to determine how long MPI results remain abnormal after transient coronary artery occlusion.


RESULTS
Patients undergoing single-vessel percutaneous coronary intervention were injected with technetium 99m sestamibi at 30 to 60 minutes (group 1) (n = 20) or 90 to 120 minutes (group 2) (n = 10) after the last balloon inflation and 24 hours later. There were 30 men aged 59 +/- 8 years. The culprit vessel was the left anterior descending artery in 14 patients and the right coronary artery in 13. The diameter stenosis was reduced from 76.1% +/- 8.7% to 3.0% +/- 6.4% (P < .001). The duration of balloon inflation was 40.3 +/- 12.5 seconds. Chest pain or ST shifts occurred in 66% of patients. A perfusion defect in the territory of the culprit artery was detected in 3 of 20 patients (15%) in group 1 and in 0 of 10 patients (0%) in group 2 (P = .3). One of those three patients had a perfusion defect on MPI done 24 hours later, along with a regional wall motion abnormality on the 2 sets of images.


CONCLUSIONS
Abnormal perfusion is seen in a small percentage of patients at 30 to 60 minutes and in none at 90 to 120 minutes after a brief transient balloon occlusion. These results might have important implications in patient care.
Aqel
Raed
R
Birmingham VA Medical Center, University of Alabama at Birmingham, Birmingham, Ala 35294, USA.
Zoghbi
Gilbert J
GJ
Bender
Luvenia W
LW
Scott
Johnny W
JW
Baldwin
Jon A
JA
Heo
Jaekyeong
J
Iskandrian
Ami E
AE
D015906:Angioplasty, Balloon, Coronary; D021721:Balloon Occlusion; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D017256:Technetium Tc 99m Sestamibi; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy*
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi