Reversible defects on myocardial perfusion imaging early after coronary stent implantation: A predictor of late restenosis

Department of Nuclear Medicine, Wonkwang University School of Medicine, 344-2 Shinyong-Dong, Iksan, Jeollabuk-do 570-711, Korea.
The International Journal of Cardiovascular Imaging (Impact Factor: 1.81). 07/2008; 24(5):503-10. DOI: 10.1007/s10554-007-9273-1
Source: PubMed


If coronary artery was treated with optimal stent implantation, myocardial perfusion in the territory supplied by a dilated coronary artery should be not reversible. However, several studies have demonstrated reversible perfusion in the territory supplied by a coronary artery with an optimally implanted stent. The main objective of this study was to evaluate the incidence of reversible defects detected by M-SPECT early after optimal PTCA with stent implantation. Its second objective was to determine the predictive value of detecting reversible defects after stent implantation for late restenosis.
About 66 patients that underwent M-SPECT within 24 h of successful PTCA with stent implantation were included. All patients were followed up clinically and angiographically. The incidence of reversible perfusion defects on M-SPECT and the rate of late restenosis in target coronary arteries were evaluated retrospectively.
Reversible perfusion defects on M-SPECT were observed in 26% of the patients and in 36% of lesions following successful PTCA with stent implantation. The incidence of late restenosis was significantly higher in patients and lesions with reversible perfusion defects (47% vs. 18%). According to binary logistic regression analysis, the presence of a reversible perfusion defects was the only independent predictor of late restenosis.

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    • "In conclusion, authors suggested that endothelial dysfunction may be a possible cause of perfusion defect following PCI. The use of stents has lowered the rates of early post-PCI false positive MPI scans and therefore, in cases concerning the adequacy of high-risk angioplasty procedure, early stress MPI scans are considered clinically useful and safe nowadays [24]. "
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