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Abstract
The present study aimed to evaluate the two modalities of the treatment of in-stent restenosis namely per-cutaneouse transluminal balloon angioplasty versus restenting using tissue Doppler imaging during dobutamine stress echocardiography. Patients and Methods: Fifty patients with a restenotic lesion in a stented single coronary artery were included in this study, 20 patients who had in- stent restenosis which were treated by percuteneouse balloon angioplasty and 30 patients who had in-stent restenosis which were treated by restenting. Patients were excluded if they had: unstable angina, rnultivessels coronary disease, recent acute myocardial infarction « 6 weeks), history of sustained ventricular tachycardia, left ventricular hypertrophy) decompensated congestive heart failure, congenital or valvular heart disease, uncontrolled hypertension, protruding thrombus in the left ventricle, unacceptable echocardiographic window.
Results: Higher association of diabetes in patients who were treated with restenting than patients treated by PTCA. The endocardial systolic velocities were greater than epicardial systolic velocities by tissue Doppler study. The EF and WMSI was an indirect predictive of ISR to detect myocardial perfusion. Myocardial wall thickness has no role to detect myocardial perfusion. it showed non significant difference between the two groups. Using pulsed wave tissue Doppler imaging to detect the MVG during DSE is an indicator to perfusion of myocardial segments in patients with rSR treated by PTCA or restenting at early and late fellow up.