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Titolo:
MYOCARDIAL SCINTIGRAPHY IN ACUTE MYOCARDIAL-INFARCTION TREATED WITH SYSTEMIC THROMBOLYSIS - HOW FAR ARE WE FROM OBTAINING RELIABLE INFORMATION FOR RESCUE PTCA
Autore:
MAZZOTTA G; PROTOSIDO SK; CASATI E; VECCHIO C;
Indirizzi:
EO OSPED GALLIERA,DIV CARDIOL,VIA VOLTA 8 I-16128 GENOA ITALY
Titolo Testata:
International journal of cardiology
, volume: 65, anno: 1998, supplemento:, 1
pagine: 69 - 73
SICI:
0167-5273(1998)65:<69:MSIAMT>2.0.ZU;2-P
Fonte:
ISI
Lingua:
ENG
Soggetto:
HEXAKIS 2-METHOXYISOBUTYL ISONITRILE; CORONARY-ARTERY REPERFUSION; METHOXYISOBUTYL ISONITRILE; NONINVASIVE ASSESSMENT; TC-99M ISONITRILE; TL-201 KINETICS; SALVAGE; THERAPY; OCCLUSION; QUANTIFICATION;
Keywords:
MYOCARDIAL SCINTIGRAPHY; THROMBOLYSIS; PTCA; ACUTE MYOCARDIAL INFARCTION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
31
Recensione:
Indirizzi per estratti:
Citazione:
G. Mazzotta et al., "MYOCARDIAL SCINTIGRAPHY IN ACUTE MYOCARDIAL-INFARCTION TREATED WITH SYSTEMIC THROMBOLYSIS - HOW FAR ARE WE FROM OBTAINING RELIABLE INFORMATION FOR RESCUE PTCA", International journal of cardiology, 65, 1998, pp. 69-73

Abstract

All noninvasive tests have an unsatisfactory accuracy in assessing patency of the infarct related vessel after systemic thrombolysis. In large infarctions, the prompt knowledge of the amount of jeopardized myocardium, as well as the eventual success of thrombolysis on the culprit lesion are major clinical needs in the subsequent decision making process, including the indication no rescue PTCA. Several reasons preclude a meaningful use of thallium scintigraphy in this setting: the mostimportant one is the need to perform pre-thrombolytic images before the administration of the active agent, implying a delay in the administration of thrombolysis that is clinically not acceptable. SestaMIBI perfusion scintigraphy at rest seems more suitable in this regard. SestaMIBI practically does not redistribute in the myocardium, and this implies that after an administration at admission in the CCU, the pre-thrombolysis images can be aquired later, without any interference with the therapeutic schedule. 'The estimate of myocardial salvage can be obtained by the comparison of the perfusion pattern derived from a later sestaMIBI injection with the pre-lysis :images. Both planar and tomographic reconstructions have satisfactory positive and negative predictive accuracy for the patency of the culprit vessel. Difficulties are related with the necessity of having this information timely; we describe a few protocols, appeared in the literature, that might contributein solving such problems. SestaMIBI imaging in patients with acute myocardial infarction should be encouraged and extended, given its potential to represent one of the best tool to judge the amount of jeopardized myocardium, the obtained salvage, and to guide the decision makingafter systemic thrombolysis. (C) 1998 Elsevier Science Ireland Ltd.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 12/07/20 alle ore 09:00:11