PMID: 9420818Sep 1, 1995Paper

Preoperative risk stratification by adenosine thallium 201 single-photon emission computed tomography in patients undergoing vascular surgery

Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology
M G KoutelouM S Verani

Abstract

Adenosine perfusion scintigraphy is a powerful technique for diagnosing coronary artery disease and risk stratifying patients with recent myocardial infarction. We investigated the use of adenosine 201Tl tomography to risk stratify 106 patients undergoing vascular arterial reconstruction consisting of lower limb arterial grafting in 44, aortic aneurysmectomy in 36, and carotid endarterectomy in 26 patients. Abnormal tomograms occurred in 57 patients (54%), 47 (82%) of whom had reversible perfusion defects. There were three postoperative deaths, all in the group that underwent aortic aneurysmectomy. Another patient with an aortic aneurysm had unstable angina and one patient who underwent lower limb arterial surgery had pulmonary edema after surgery. No patient without transient defects had an event (negative predictive value 100%). Cardiac events occurred only in patients with transient perfusion defects. However, only 5 of 47 such patients had events (positive predictive value 11%). The perfusion defect size (23% +/- 14% vs 8.9% +/- 135; p = 0.034) and the ischemic fraction (20% +/- 16% vs 5.6% +/- 8.9%; p = 0.009) were 2.5- and 3.5-fold larger, respectively, in patients with than in those without events. A history of diabetes ...Continue Reading

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Citations

May 8, 2004·European Journal of Nuclear Medicine and Molecular Imaging·S R UnderwoodUNKNOWN Royal College of Radiologists
Jun 3, 2004·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Kenneth A Brown
Jul 21, 1998·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·J A Leppo, S T Dahlberg
Mar 12, 2004·British Journal of Anaesthesia·S J HowellP Foëx
May 4, 2011·Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine·Howard Weinstein, Richard Steingart

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