Angiographic follow-up after multivessel percutaneous transluminal coronary angioplasty

• Published in: The American journal of cardiology Vol. 60; no. 7; pp. 467 - 470
• Main Authors: Finci, Leo, Meier, Bernhard, De Bruyne, Bernard, Steffenino, Giuseppe, Divernois, Jacques, Rutishauser, Wilhelm
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.09.1987; Elsevier
• Subjects: Angiography; Angioplasty, Balloon; Biological and medical sciences; Cardiology. Vascular system; Coronary Angiography; Coronary Circulation; Coronary Disease - diagnostic imaging; Coronary Disease - therapy; Coronary heart disease; Exercise Test; Female; Follow-Up Studies; Heart; Humans; Male; Medical sciences; Middle Aged; Recurrence; Time Factors; Human; Multiple; Radiodiagnosis; Coronary artery; Cuffed tube; Instrumentation therapy; Cardiovascular disease; Instrumental dilatation; Coronary arteriography; Coronary heart disease; Percutaneous route; Restenosis; Supervision
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/0002-9149(87)90287-6

In 100 consecutive patients undergoing multivessel percutaneous transluminal coronary angioplasty (PTCA), dilation was attempted in 207 arteries. Primary success was achieved in 85 patients. Complications occurred in 8 patients: acute myocardial infarction in 5 and need for emergency coronary artery bypass surgery in 5. Control angiography was done in 77 of 85 patients (91%) with primary success at a mean of 12 ± 6 months. Complete revascularization had been achieved in 59 patients and incomplete revascularization in 18. Angiographic restenosis was found in 39 of 77 patients (51%) and in 47 of 143 arteries (33%) at 9 ± 7 months. The restenosis rate was 57% for chronic total occlusions (8 of 14) and 30% for stenoses (39 of 129). The restenosis rate was significantly higher for the left anterior descending coronary artery (40%) than for the left circumflex coronary artery (21%). However, the significance was lost after exclusion of chronic total occlusions. A higher residual stenosis and a high coronary wedge pressure were predictors for restenosis. Restenosis was clinically silent in 14 patients (18%). Repeat PTCA was done in 19 patients with recurrence and elective surgery in 8. Clinical follow-up was available in all patients at 24 ± 12 months. Patients with incomplete revascularization had less favorable clinical follow-up results than patients with complete revascularization: 44% (8 of 18) vs 81% (48 of 59) were asymptomatic (p < 0.005), and 28% (5 of 18) vs 5% (3 of 59) had undergone elective bypass surgery during follow-up (p < 0.005). Most patients with restenosis after multivessel PTCA had only 1-vessel restenosis and only 7% had restenosis of all lesions.