Transthoracic, harmonic mode, contrast enhanced color Doppler echocardiography in detection of restenosis after percutaneous coronary interventions. Prospective evaluation verified by coronary angiography

doi:10.1016/j.euje.2003.10.004

European Journal of Echocardiography 2004 5(1):51-64; doi:10.1016/j.euje.2003.10.004
© 2004 by European Society of Cardiology

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Transthoracic, harmonic mode, contrast enhanced color Doppler echocardiography in detection of restenosis after percutaneous coronary interventions. Prospective evaluation verified by coronary angiography

Marek Krzanowski^a^,*, Wojciech Bodzo $n$ ^a, Dariusz Dudek^b, Grzegorz Heba^b, Marcin Rzeszutko^a, Rafa $l$ Ni $z$ ankowski^a, Jacek Dubiel^b and Andrzej Szczeklik^a

^aDepartment of Medicine, Jagiellonian University School of Medicine, 8 Skawi $n$ ska Str., 31-066 Cracow, Poland
^b2nd Department of Cardiology and Department of Interventional Cardiology, Jagiellonian University School of Medicine, 17 Kopernika Str., Cracow, Poland

Received 24 July 2003; received in revised form 20 October 2003; accepted after revision 21 October 2003.

^* Corresponding author. Tel.: +48-12-430-53-50; fax: +48-12-430-52-03. mmkrzano{at}cyf-kr.edu.pl

Abstract

Aims: To test the feasibility and accuracy of transthoracic,harmonic mode, contrast enhanced Doppler echocardiographic assessmentof lesion severity after PCI treatment in native coronary arteries—theLAD, Cx and RCA.

Methods and results: Prospective evaluation of 59 patients (66arteries). Restenosis was diagnosed whenever maximal flow velocityat least doubled in comparison to the segment immediately proximalto the PCI site or when local velocity was at least 2 m/s. At9 months of follow-up final comparison of Doppler echocardiographyand coronary angiography was performed with regard to 44 arteriesin 40 patients. Of LAD segments assessed, 15 were proximal and15 middle. The figures for Cx segments were: 4 proximal and2 mid, and for RCA 2 proximal, 5 middle and 1 distal (i.e. theposterior descending coronary artery).

On final coronary angiography there were 8 restenoses—allcorrectly diagnosed by echocardiography. There were 2 false-positivediagnoses of restenosis. Specificity for restenosis detectionwas 94% and sensitivity 100%.

Conclusion: Transthoracic echocardiography allowed for accuratestenosis assessment of principal coronary arteries after successfulPTCA. Feasibility of lesion site visualization was 100% forthe LAD, 75% for the Cx and 43% for the RCA. Ultrasound contrastagent improved the quality of the RCA images.

Keywords: Doppler echocardiography; coronary artery; ultrasound contrast agent; restenosis; PCI

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