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Significant multi-vessel stenoses of the coronary arteries are definitely treated with aorto-coronary by-pass grafting. Most often, the procedure is complicated with acute and subacute occlusion of the graft. Diabetics are high-risk patients, requiring more complex pre- and postoperative diagnostic work-up. Percutaneous transluminal coronary dilatation with stenting (PTCA) has been a well-established procedure of choice for the resolution of the occlussion over the last few years. The aim is to present a case of a diabetic patient, whose work-up and follow-up included all parts of the diagnostic-therapeutic pyramid in the treatment of the coronary disease. Given its characteristics, sensitivity, specificity and reproducibility, myocardial perfusion scintigraphy (MPS) should be an unavoidable step in the post-operative follow-up of diabetics with coronary disease. Myocardial perfusion scintigraphy proved highly efficient in assessing the grafts, as it renders morphological and functional data on the myocardial status that is directly proportional to the coronary arteries status.
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