Important role of cardiac spect imaging in patients undergoing percutaneous transluminal coronary angioplasty.

Objective: To examine the utilization and contribution of cardiac perfusion scans to patients undergoing percutaneous transluminal coronary angioplasty.
Methods: From July 1996 to January 1998, 34 patients underwent percutaneous transluminal coronary angioplasty and cardiac SPECT imaging was studied. Twenty-five patients had pre-procedure SPECT scans. The agreement between angioplasty strategies and SPECT findings of ischemia and hypokinesia was examined.
Results: When radionuclide imaging was performed before revascularization procedures, 84% of the patients had intervention strategies guided by scan findings. Perfusion scan findings including extent and severity of ischemia, degree of hypokinesia directed the selection of target vessel for angioplasty in the patient subgroup with multi-vessel disease. Post-angioplasty radionuclide cardiac scans were performed only on symptomatic patients, demonstrating ischemia and hypokinesia in most of them, conceivably reflected the selection bias.
Conclusion: We recommend routine pre- and post-angioplasty radionuclide imaging with multigated scans for wall motion assessment for all patients receiving coronary intervention.