Thallium-201 myocardial perfusion imaging in patients before and after successful percutaneous transluminal coronary angioplasty

We studied the value of exercise thallium-201 (Tl-201) scintigraphy for evaluation of myocardial perfusion improvement and the detection of restenosis in patients after successful percutaneous transluminal coronary angioplasty (PTCA). Fifty-three patients (43 male and 10 female) ages 38–71 years (mean 55.3) were analysed. Exercise Tl-201 scintigraphy was performed before PTCA, and 6–10 days and then 3–6 months after the procedure. In all patients repeated coronary angiography was done 3–6 months after PTCA. Before PTCA myocardial perfusion defects were observed in all patients. Immediately after PTCA, an improvement in myocardial perfusion was noted in 36 patients (61%). Total normalisation of the scintigraphic picture was observed in only 12 patients. Coronary angiography after 3–6 months showed patency of dilated vessels in 11 out of those 12 patients (91.3%). In scintigraphy, performed 3–6 months after PTCA, a normal scan was present in 20 patients and recurrence of stenosis was found in only 2 of those 20. Stenosis was found in 22 (60%) of 33 patients with perfusion defects. For the purpose of describing the character of the myocardial perfusion changes, statistical analysis of a number of segments was performed. The predictive value of Tl-201 scintigraphy for detection of restenosis was established. The positive value for the procedure performed 6–10 days after PTCA was 56%, and the negative value of prediction of restenosis was 91%. Three to 6 months after PTCA, a high negative value of scintigraphy was observed (− 90%) and a low positive predictive value was still present (63%).