Immediate and short-term results of a 1988-1989 coronary angioplasty registry

To determine the relevance of recent refinements in angioplasty technology to our particular practice, the records of 507 consecutive patients undergoing a first percutaneous transluminal coronary angioplasty (PTCA) at our center between October 1988 and May 1989 were reviewed. At the time of PTCA, 41% of these patients had class IV angina and 44% were identified as having multivessel disease. Dilatation was attempted in 734 lesions (mean 1.5 per patient), of which 95 (13%) were chronic total occlusions. Overall, 69% of the 734 lesions were judged anatomically complex, and, in dilating these lesions, a rail-type device was used almost exclusively. Successful dilatation was achieved in 659 of the 734 (90%) attempted lesions. There were low incidences of the major complications of death (0.4%), myocardial infarction (1.8%) and emergency bypass surgery (1.8%). Acute rethrombosis occurred in 54 patients (11). in these patients, initial strategy of repeat dilatation was successful in 38 of 47 patients (81%). Overall, primary clinical success at PTCA was achieved in 480 patients (95%). At a mean follow-up of 7.5 [plus or minus] 1.5 months in 497 of the study patients, the event-free rate (freedom from cardiac death, myocardial infarction, repeat PTCA or coronary bypass surgery or recurrence of severe [class ill to IV] angina) was 71%. in conclusion, despite the often complex coronary disease in patients currently presenting to our center, a high initial success rate and acceptable short-term outcome of PTCA was achieved. (Am J Cardiol 1991;67:253-258)
Coronary artery disease (CAD) involves stenosis (narrowing) of the arteries supplying the heart with blood, to the extent that cardiac blood flow is compromised. This is usually caused by the formation of fatty atherosclerotic plaques on the inner surface of the arteries. A common treatment for CAD is percutaneous transluminal coronary angioplasty (PTCA), in which a catheter with an inflatable balloon tip is passed through the blood vessels to the occluded region of the coronary arteries, inflated (distending the narrowed region to restore blood flow), and removed. In recent years, improved maneuverability of the catheter system has increased the success rate for this procedure. To obtain an overview of how successful the use of one particular type of angioplasty device (the rail-type dilatation system) has been, the records of 507 consecutive patients undergoing their first PTCA at a Belgian cardiology practice between October 1988 and May 1989 were reviewed. At the time PTCA was performed, 41 percent of the patients had very severe angina pectoris (chest pains resulting from the CAD), and 44 percent had CAD afflicting two or more coronary blood vessels (multivessel CAD). Angioplasty was attempted on 734 narrowed arterial segments (an average of 1.5 per patient); 95 percent of these were total chronic occlusions. Successful restoration of blood flow was obtained in 90 percent of the cases. Low incidence of death (0.4 percent), heart attack (1.8 percent) and the need for emergency bypass surgery (1.8 percent) was noted. Recurrence of the blockage was seen in 11 percent of the patients; 81 percent of these were successfully treated with a repeat PTCA procedure. At 7.5-month (average) follow-up, 71 percent of the procedures were judged to have been successful (i.e. no incidence of cardiac death, heart attack, repeat PTCA, bypass surgery, or recurrence of severe angina pectoris). (Consumer Summary produced by Reliance Medical Information, Inc.)