Myocardium perfusion scintigraphy in evaluation of endovascular treatment results of coronary artery disease

Purpose: To determine abilities and principal features of prospective scintigraphic evaluation of endovascular treatment results of coronary artery disease (CAD) using thallium-199 perfusion single-photon emission computed tomography. Material and methods: Forty CAD patients were investigated by perfusion scintigraphy before and 2-3 weeks, 3-6 months and 1-2 years after coronary artery stenting. The character and size of perfusion defects and presence of the reverse radionuclide redistribution phenomenon were estimated. Results: The coronary stenting almost results to the 80 % decrease of mean size of transitory ischemic zones. The presence of reversible perfusion defects after operation was bound up with the incomplete revascularization or with X-syndrome. At later time periods of the observation, the unfavorable course of coronary insufficiency was due to coronary artery restenosis. Mean value of persistent perfusion defects has not changed after endovascular treatment, but 11 patients have demonstrated disappearance or volume decrease of stable ischemic zones at early and late postoperative period, that has testified to myocardial viability. In group of patients with rapid wash-out of thallium ("reverse redistribution" (RR)) there was the occurrence of new reversible and stable perfusion defects in projection of previous existence of RR. The condition of microcirculation of the heart muscle has not undergo remarkable changes in the group of patients without RR. Conclusion: Myocardium thallium-199 chloride perfusion scintigraphy is the objective method for evaluation of coronary stenting results and restenosis diagnostics. It allows to determine hibernating myocardium in CAD patients and discover unfavorable scintigraphy predictors for possible cardiovascular events.