Cardiac imaging for the detection of ischemia after percutaneous coronary intervention

Percutaneous coronary intervention (PCI) is increasingly used to treat coronary heart disease. Despite major technologic advances, however, not even drug-eluting stents confer long-term immunity from cardiac events, as disease progression causes significant morbidity after PCI. Myocardial perfusion imaging (MPI) accurately detects ischemia and stratifies risk when performed 2 months or more after PCI. Coronary computed tomography angiography may also have an important role in the assessment of patients after PCI: it permits direct imaging of restenotic lesions and obstructive plaque, and facilitates assessment of non obstructive plaque, which is not detectable with MPI, but is frequently responsible for hard cardiac events. Heart Metab. 2006;31:13–16.