원저 : 우측 관상동맥 폐쇄 환자에서 관상동맥내 Thallium - 201 주사를 이용한 측부 혈행의 의의 ( Functional Significance of Angiographic Collaterals in Patients with Totally Occluded Right Coronary Artery : Intracoronary Thallium - 201 Scintigraphy ) () |
Author |
이도연(Do Yun Lee),이종두(Jong Doo Lee),조승연(Seung Yun Cho),심원흠(Won Heum Shim),하종원(Jong Won Ha),김한수(Han Soo Kim),권혁문(Hyuk Moon Kwon),장양수(Yang Soo Jang),정남식(Nam Sik Chung),김성순(Sung Soon Kim),박창윤(Chang Yun Park),김용수(Young Soo Kim), |
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Affiliation |
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Abstract |
To compare the myocardial viability in patients
suffering from total occlusion of the right coronary
artery (RCA) with the angiographic collaterals,
intracoronary injection of Thallium-201 (T1-201) was
done to 14 coronary artery disease (CAD) patients (pts)
with total occlusion of RCA and into four normal
subjects for control. All 14 CAD pts had Grade 2 or 3
collateral circulations. There were 14 male and 4
females, and their ages ranged from 31 to 70 years. In
nine pts, T1-201 was injected into left main coronary
artery (LCA) (300∼350 μCi) to evaluate the myocardial
viability of RCA territory through collateral
circulations. The remaining five pts received T1-201
into RCA (200-250 μCi) because two had intraarterial
bridging collaterals and three had previous successful
PTCA. Planar & SPECT myocardial perfusion images were
obtained 30 minutes, and four to five hours after T1-
201 reinjection. Intravenous T1-201 reinjection (six
pts) or Tc-99m-MIBI (two pts) were also performed in
eight CAD pts. Intracoronary myocardial perfusion
images were compared with intravenous T1-201(IV T1-201)
images, EGG, and ventriculography. Intracoronary TI-201
images proved to be superior to that of IV T1-201 due
to better myocardial to background uptake ratio and
more effective in the detection of viable tissue. We
also found that perfusion defects were smaller on
intracoronary T1-201 images than those on the IV T1-
201. All of the 14 CAD pts had either mostly viable
myocardium (seven pts) or large area of T1-201
perfusion (seven pts) in RCA territory, however
ventriculographic wall motion and ECG did not correlate
well with intracoronary myocardial perfusion images. In
conclusion, total RCA occlusion patients with well
developed collateral circulation had large area of
viable myocardial in the corresponding territory. |
Keyword |
Myocardial viability, Intracoronary Tl-201 Scan, Collateral circuiation, Tl-201 Scintigraphy, Coronary arterial obstrctive disease |
Full text Article |
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