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Original ArticleOpen Access
Detection of Restenosis After Percutaneous Transluminal Coronary Angioplasty Using the Exercise Treadmill Test and Technetium 99m-Sestamibi Scintigraphy
Srimahachota S 
,
Limpijankit T ,
Boonyaratavej S ,
Tepmongkol S ,
Udayachalerm W ,
Suithichaiyakul T ,
Ngarmukos P
,
Limpijankit T ,
Boonyaratavej S ,
Tepmongkol S ,
Udayachalerm W ,
Suithichaiyakul T ,
Ngarmukos P Background : The detection of myocardial ischemia after percutaneous transluminal
coronary angioplasty (PTCA) is important because 30-50 per cent of the patients will develop
restenosis within 6 months. Symptoms of chest pain and exercise stress test (EST) have
shown to be less sensitive for detection of ischemia than exercise Technetium-99m Sestamibi
(Tc-99m MIBI). The purpose of this study was to compare the sensitivity and specificity of
chest pain, EST and Tc-99m MIBI with coronary angiography (CAG).
Method : Tc-99m MIBI with SPECT imaging was performed at months 1, 3 and 6
and CAG was repeated 6 months after successful PTCA. Earlier Tc-99m MIBI and CAG were
performed in patients with recurrent angina pectoris or suspected restenosis.
Results : Forty six patients (M 29, F 17) who had undergone successful angioplasty
were prospectively enrolled. Their mean age was 61
เธ‘
19 yrs. Eighty eight lesions (LAD63%,
LCX34%, RCA19%) were performed. Lesion characteristics were type A in 9 per cent, type
in B 30 per cent and type C in 61 per cent. Fifty four per cent of PTCA were performed for
single vessel disease and 46 per cent for multivessel disease. The mean duration of time
between PTCA and follow-up CAG was 6.1
เธ‘
2.7 months. We detected restenosis from CAG
in 58 per cent of the cases. The Tc-99m MIBI had higher sensitivity to detect restenosis than
anginal pain (85.0%
vs
39.4% p
<
0.005) or EST (85.0%
vs
63.6% p
<
0.05) when compared
with CAG. The overall accuracy of Tc-99m MIBI for the detection of restenosis was 80 per cent.
C~nclusion
: Tc-99m MIBI with SPECT imaging constitutes a better means than
symptoms or exercise test to detect restenosis after successful coronary angioplasty.
Key word : Technetium-99m Sestamibi, Coronary Angioplasty, Restenosis
coronary angioplasty (PTCA) is important because 30-50 per cent of the patients will develop
restenosis within 6 months. Symptoms of chest pain and exercise stress test (EST) have
shown to be less sensitive for detection of ischemia than exercise Technetium-99m Sestamibi
(Tc-99m MIBI). The purpose of this study was to compare the sensitivity and specificity of
chest pain, EST and Tc-99m MIBI with coronary angiography (CAG).
Method : Tc-99m MIBI with SPECT imaging was performed at months 1, 3 and 6
and CAG was repeated 6 months after successful PTCA. Earlier Tc-99m MIBI and CAG were
performed in patients with recurrent angina pectoris or suspected restenosis.
Results : Forty six patients (M 29, F 17) who had undergone successful angioplasty
were prospectively enrolled. Their mean age was 61
เธ‘
19 yrs. Eighty eight lesions (LAD63%,
LCX34%, RCA19%) were performed. Lesion characteristics were type A in 9 per cent, type
in B 30 per cent and type C in 61 per cent. Fifty four per cent of PTCA were performed for
single vessel disease and 46 per cent for multivessel disease. The mean duration of time
between PTCA and follow-up CAG was 6.1
เธ‘
2.7 months. We detected restenosis from CAG
in 58 per cent of the cases. The Tc-99m MIBI had higher sensitivity to detect restenosis than
anginal pain (85.0%
vs
39.4% p
<
0.005) or EST (85.0%
vs
63.6% p
<
0.05) when compared
with CAG. The overall accuracy of Tc-99m MIBI for the detection of restenosis was 80 per cent.
C~nclusion
: Tc-99m MIBI with SPECT imaging constitutes a better means than
symptoms or exercise test to detect restenosis after successful coronary angioplasty.
Key word : Technetium-99m Sestamibi, Coronary Angioplasty, Restenosis
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