The value of transient ischemic dilation for detecting restenosis after coronary artery revascularization.
Transient ischemic dilation (TID) is a marker of severe coronary artery disease (CAD). We aimed to assess the incremental value of TID in a cohort of patients with known significant CAD who had recurrence of symptoms after revascularization.



We identified in our databases 104 patients who had recent coronary revascularization and recurrence of symptoms. 62 patients had PCI (75 arteries) and 42 patients had CABG (104 arteries). All had follow-up stress SPECT MPI and repeat coronary angiography. Myocardial perfusion findings of ischemia and TID were correlated with presence of significant obstructive CAD (>70% stenosis).



Follow-up stress Tc-99m Sestamibi SPECT MPI revealed inducible ischemia in 38 patients (36.5%) and TID > 1.20 in 49 patients (47%). Subsequent coronary angiography showed significant obstructive CAD in 44 patients (42%). The sensitivity for detecting obstructive CAD was 61% for SPECT MPI alone, but increased significantly to 93% by the addition of TID as a diagnostic criterion (P < 0.0001).



In this selected patient cohort with prior coronary revascularization, TID is an important marker of obstructive CAD and has incremental value over SPECT MPI alone.
Department of Nuclear Medicine, Ministry of Health, Diskapi Yildirim Beyazit Training and Research Hospital, Etlik, Ankara, Turkey. gultekinsinan@gmail.com.
Salih Sinan
SS
Gultekin
Department of Nuclear Medicine, Ministry of Health, Ankara Training and Research Hospital, Ulucanlar Street, 06560, Ankara, Turkey.
Murat
M
Sadic
Department of Cardiology, Ministry of Health, Diskapi Yildirim Beyazit Training and Research Hospital, Altindag, Ankara, Turkey.
Murat
M
Bilgin
Department of Nuclear Medicine, Ministry of Health, Ankara Training and Research Hospital, Ulucanlar Street, 06560, Ankara, Turkey.
Gökhan
G
Koca
Department of Cardiology, Ministry of Health, Diskapi Yildirim Beyazit Training and Research Hospital, Altindag, Ankara, Turkey.
Sadik
S
Acikel
Department of Cardiology, Ministry of Health, Diskapi Yildirim Beyazit Training and Research Hospital, Altindag, Ankara, Turkey.
Ekrem
E
Yeter
Department of Nuclear Medicine, Ministry of Health, Ankara Training and Research Hospital, Ulucanlar Street, 06560, Ankara, Turkey.
Meliha
M
Korkmaz
D000368:Aged; D003251:Constriction, Pathologic; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D023903:Coronary Restenosis / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D004106:Dilatation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia; D055414:Myocardial Perfusion Imaging; D009204:Myocardial Revascularization; D062645:Percutaneous Coronary Intervention; D012372:ROC Curve; D012008:Recurrence; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon
D017256:Technetium Tc 99m Sestamibi
Coronary artery disease; coronary revascularization; myocardial perfusion imaging: SPECT; transient ischemic dilation