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(Circulation. 2004;109:2156.)
© 2004 American Heart Association, Inc.

Images in Cardiovascular Medicine

Coronary Uptake of Gallium-67 Citrate After Implantation of Sirolimus-Eluting Stent

Leonard Kritharides, MBBS, PhD; John Yiannikas, MBBS; David Brieger, MBBS, PhD; Kevin Allman, MBBS

From the Departments of Cardiology (L.K., J.Y., D.B.) and Nuclear Medicine (K.A.), Concord Hospital, University of Sydney, NSW, Australia.

Correspondence to L. Kritharides PhD, FRACP, Department of Cardiology Concord Hospital, Hospital Rd Concord 2139, NSW, Australia. E-mail l.kritharides@unsw.edu.au

An extract of the first 250 words of the full text is provided, because this article has no abstract.

A 65-year-old woman with a history of stable angina pectoris, hypertension, and hypercholesterolemia underwent elective percutaneous coronary intervention (PCI) for a 90% stenosis of the proximal right coronary artery (RCA), with deployment of a 2.75 mm x 13 mm rapamycin-eluting Cypher stent (Cordis), and was discharged taking aspirin, clopidogrel, simvastatin, and perindopril. Seven months after PCI, the patient developed myalgia and began to lose weight. Clinical examination was unremarkable; however, the erythrocyte sedimentation rate was elevated. To exclude lymphoma, a nuclear gallium scan (⁶⁷Ga citrate, Figure) was performed. The scan revealed unusual high intensity uptake of gallium localized to the course of the RCA. Gallium scan repeated 4 months later (11 months after PCI) showed identical persisting uptake within the RCA. At this time, magnetic resonance imaging demonstrated mild gadolinium enhancement in the region of the pericardial reflection around the superior vena cava and aortic origin, in proximity to the region of abnormal gallium accumulation. Cardiac ultrasound showed a small pericardial effusion, and repeat coronary angiography and intravascular ultrasound showed that the stent was widely patent, without extravasation of coronary contrast, with normal apposition of the stent against the coronary wall (not shown). A white cell scan performed to exclude the presence of a neutrophil infiltrate (which would reflect an infective cause) was negative. The patient remains stable 11 months after stent deployment on low-dose prednisone.

View larger version (57K): [in this window] [in a new window]   Thoracic sagittal (A) and frontal (B) sections from gallium tomography showing intense abnormal uptake in the region of the proximal RCA extending . . . [Full Text of this Article]

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