Usefulness of Myocardial Perfusion SPECT after Percutaneous Coronary Intervention (PCI)

경피적 관상동맥 중재술(Percutanerous Coronary Intervention; PCI) 후 심근 관류 SPECT의 유용성

  • Lee, Jong-Jin (Department of Nuclear Medicine, Seoul National University College of Medicine) ;
  • Lee, Dong-Soo (Department of Nuclear Medicine, Seoul National University College of Medicine)
  • 이종진 (서울대학교 의과대학 핵의학교실) ;
  • 이동수 (서울대학교 의과대학 핵의학교실)
  • Published : 2005.04.30

Abstract

As the indication of percutaneous coronary intervention (PCI) has expanded to the more difficult and complicated cases, frequent restenosis is still expected after PCI. According to AHA/ACC guideline of the present time, routine use of myocardial perfusion single photon emission tomography (SPECT) is not recommended after coronary intervention, but symptom itself or exercise EKG is not enough for the detection of restensis or for the prediction of event-free survival. In high risk and/or symptomatic subjects, direct coronary angiography is required myocardial perfusion SPECT could detect restenosis in 79% of the patients if performed 2 to 9 months after PCI. Reversible perfusion decrease in the myocardial perfusion SPECT is known to be the major prognostic indicator of major adrerse cardiac event in PCI patients and also the prognosis is benign in the patients without reversible perfusion decrease. Though the cumulated specificity is 79% in the literature and optimal timing of myocardial perfusion SPECT is in controversy, SPECT is recommended even in asymptomatic patients at 3 to 9 months after PCI. Considering the evidences recently reported in the literature, myocardial perfusion SPECT is useful for risk stratification and detection of coronary artery restenosis requiring re-intervention in the asymptomatic patients after PCI.

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