Polar Presentation of Coronary Angiography and Thallium-201 Single Photon Emission Computed Tomography

1989 ◽  
Vol 30 (6) ◽  
pp. 561-574 ◽  
Author(s):  
B. Svane ◽  
D. Bone ◽  
A. Holmgren ◽  
C. Landou
Keyword(s):  
Coronary Angiography ◽  
Coronary Arteries ◽  
Single Photon ◽  
Photon Emission ◽  
Ventricular Myocardium ◽  
Left Ventricular ◽  
Thallium 201 ◽  
Left Ventricular Myocardium ◽  
Emission Computed Tomography ◽  
Perfusion Defects

Individual results of coronary angiography were compared with tomographic myocardial scintigraphy (SPECT) in 99 patients. Coronary angiography findings were transferred to polar maps. Borders between arteries were assigned angles in a coordinate system constructed as a compass-rose. Areas perfused by different arteries were described by sectors. Findings were visually compared with the perfusion defects in a polar presentation of thallium-201 SPECT also described by angles. The mean values and SD for the angles representing arterial borders and perfusion defects were presented. The left ventricular myocardium was perfused by 3 coronary arteries in 92/99 patients. Dominant left artery was present in 7/99 patients; 79 perfusion defects were related to 118 arterial sectors 84 per cent had totally or partially matched stenotic arteries. Inter-individual differences in distribution of coronary arteries influence the localization of perfusion defects in myocardial SPECT and can be estimated with this polar presentation method.

Percutaneous or surgical revascularization is associated with survival benefit in stable coronary artery disease

2020 ◽  
Vol 21 (9) ◽  
pp. 961-970 ◽  
Author(s):  
Robert J H Miller ◽  
Robert O Bonow ◽  
Heidi Gransar ◽  
Rebekah Park ◽  
Piotr J Slomka ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Survival Benefit ◽  
Single Photon ◽  
Artery Bypass ◽  
Photon Emission ◽  
Left Ventricular ◽  
Left Ventricular Myocardium ◽  
Emission Computed Tomography ◽  
All Cause Mortality ◽  
Early Revascularization

Abstract Aims  We assessed the association between early invasive therapy, burden of ischaemia, and survival benefit separately for percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). Ischaemia involving more than 10% of the left ventricular myocardium may identify patients who benefit from revascularization. However, it is not clear whether this association exists with both PCI and CABG. Materials and results Patients who underwent single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) between 1992 and 2012 were identified. Early revascularization was defined as PCI or CABG performed within 90 days of SPECT MPI. The association between early PCI or CABG and all-cause mortality was assessed using a doubly robust, propensity score matching analysis. In total, 54 522 patients were identified, with median follow-up 8.0 years. Early PCI was performed in 2688 patients and early CABG in 1228. In the matched cohorts, early revascularization was associated with improved survival compared to medical therapy in patients with more than 15% ischaemia for both PCI [adjusted hazard ratio (HR) 0.70, P = 0.002] and CABG (adjusted HR 0.73, P = 0.008). Conclusion  In this observational analysis, both PCI and CABG were associated with reduced all-cause mortality in the presence of moderate to severe ischaemia after adjusting for factors leading to revascularization. As the threshold for improved outcomes with revascularization was similar for PCI and CABG, our results suggest that decisions for PCI vs. CABG for early revascularization should be determined by coronary anatomy, patient characteristics, and shared decision making, but not by the burden of ischaemia.

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