Myocardial Perfusion SPECT Imaging in Patients after Percutaneous Coronary Intervention

Abstract

Coronary artery disease (CAD) is the most prevalent form of cardiovascular disease affecting about 13 million Americans, while more than one million percutaneous transluminal intervention (PCI) procedures are performed annually in the USA. The relative high occurrence of restenosis, despite stent implementation, seems to be the primary limitation of PCI. Over the last decades, single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI), has proven an invaluable tool for the diagnosis of CAD and patients' risk stratification, providing useful information regarding the decision about revascularization and is well suited to assess patients after intervention. Information gained from post-intervention MPI is crucial to differentiate patients with angina from those with exo-cardiac chest pain syndromes, to assess peri-intervention myocardial damage, to predict-detect restenosis after PCI, to detect CAD progression in non-revascularized vessels, to evaluate the effects of intervention if required for occupational reasons and to evaluate patients' long-term prognosis. On the other hand, chest pain and exercise electrocardiography are largely unhelpful in identifying patients at risk after PCI.Although there are enough published data demonstrating the value of myocardial perfusion SPECT imaging in patients after PCI, there is still debate on whether or not these tests should be performed routinely.

Keywords: Myocardial Perfusion Imaging (MPI); Percutaneous Coronary Intervention (PCI); Revascularization.; SPECT.

Fig. (1)

Myocardial perfusion SPECT imaging of a 61-years old patient with one-vessel disease (LAD 95%) before (A) and 6 months after (B) LAD PCI, demonstrated significant improvement in the apex, anterior wall and septum.