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H. Hecht, R. Shaw, H. Chin, C. Ryan, S. Stertzer, R. Myler (1991)
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From the Sun Francisco Heart Institute. Seton Medical Center, Duly City. California Introduction The conventional definition of restenosis involves the use of angiographic parameters and is not universally agreed upon. The pitfalls of relying on angiography alone for the determination of the severity of a given coronary stenosis and the merits of utilizing coronary flow reserve have been extensively discussed' and are beyond the scope of this article. An alternative approach to analysis of the coronary lesion itself either qualitatively, quantitatively, or by coronary flow reserve is to determine the significance of the stenosis by measuring its effect on myocardial perfusion or function. The currently available imaging techniques for evaluating the significance of a coronary stenosis and by extension, a coronary restenosis, include tomographic (single photon emission computed tomography [SPECT]) thallium-201 and technetium 99m myocardial perfusion imaging, "Rb or '3N-ammonia positron emission tomography (PET), and stress echocardiogrdphy. The evaluation of restenosis by any of these techniques implies the existence of a flow limiting lesion that, in the case of SPECT thallium-201 imaging and PET, is severe enough to produce disparities in myocardial perfusion in response to a hyperemic stimulus, either exercise or pharmacological vasodilatation. Stress echocardiography requires a
Journal of Interventional Cardiology – Wiley
Published: Dec 1, 1991
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