Circulation, Vol 68, 148-154, Copyright © 1983 by American Heart Association
T Ischinger, AR Gruentzig, J Hollman, S King 3d, J Douglas, B Meier, J Bradford and R Tankersley
We evaluated all patients receiving percutaneous transluminal coronary
angioplasty (PTCA) in the past year for mild stenosis (60% or less diameter
narrowing, n = 64, group 1) and compared them with a random sample of 330
patients with greater than 60% stenosis (n = 66, group 2) treated during
the same year. The degree of coronary stenosis before PTCA was 52 +/- 7%
(mean +/- SD) in group 1 and 79 +/- 11% in group 2. The primary success
rate was 90% (58 of 64 patients) in group 1 vs 86% (57 of 66 patients) in
group 2. The incidence of complications requiring coronary surgery after
PTCA failed was similar in both groups (3 of 64 in group 1, 4 of 66 in
group 2), but there were four occurrences of myocardial infarction in group
1 and none in group 2 (p less than .05). Recurrence of stenosis was judged
on the basis of objective data, 76% of which were angiographic data, in 97%
of the patients with primary success. At a mean interval of 5 months with a
mean follow-up period of 7 months, 17 of 58 patients (29%) with primary
success in group 1 and 24 of 57 patients (42%) in group 2 developed
restenosis. In group 1, restenosis was markedly more severe (73 +/- 15%)
than initial stenosis (p less than .005), which was not the case in group
2. In conclusion, PTCA in mild stenosis has favorable primary and long-term
results, yet carries the risk of myocardial infarction and emergency
operation and may, in some cases, even accelerate the disease process.
ARTICLES
Should coronary arteries with less than 60% diameter stenosis be treated by angioplasty?
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