Document Detail

Optimal ("stent-like") acute angiographic results pursuable by traditional PTCA.
MedLine Citation:
PMID:  9834859     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: This study was undertaken: 1) to assess the efficacy of traditional PTCA in affording "optimal" initial dilatation (OID) of coronary stenoses (as assessed by on-line quantitative angiography) defined as a post-procedure residual lumen narrowing < or = 20%; 2) to determine clinical and angiographic correlates of these types of successes. BACKGROUND: Recent reports have shown that acute angiographic results achieved by traditional PTCA, resembling those obtainable by elective stenting, carry low risks of restenosis. However, safety and the ability of conventional PTCA to consistently provide acute stent-like results are still practically unknown. PATIENTS AND METHODS: Using a "standardized" procedural protocol intended to optimize acute angiographic results, 878 consecutive non-selected patients, 750 men and 128 women aged 29-78 years (mean 60.5 yrs) underwent PTCA on 1054 lesions. Compliant balloons reaching nominal dimensions at 6 atm and predicted balloon-artery ratios of 0.92-1.05 (mean 1.02) were used. An inflation pressure of 5 atm was gradually and slowly applied initially (usually sufficient to reach the point of plaque fracture). Inflation times of 60 seconds and step-increases in inflation pressure of 1 atm were subsequently utilized, until a large lumen with smooth contours (the nearest to normal) or any wall damage were detected by angiographic tests performed at each step. Inflations were stopped when, even in the presence of sub-optimal dilatation, the inflation pressure of 14 atm was reached (which usually corresponded to an effective balloon/artery ratio < 1.15). RESULTS: Overall traditional primary successes were 830 (94.5%) for patients and 1001 (95%) for lesions. Major complications, without mortality, were 24 (2.7%). CABS was necessary in 17 patients (1.9%) while acute myocardial infarction occurred in 7 patients (0.8%). OID was obtained in 65.4% of the treated lesions: 77.9% in type A, 73.9% in B1, 54.0% in B2 and 32.5% in C lesion subgroups of the AHA/ACC classification scheme. Multivariate analysis showed that no clinical variables significantly influenced OID. Lesion-related variables such as chronic occlusion, diffuse disease, length > 10 mm, heavily calcified and markedly angulated lesions emerged as (negative) determinants of success. CONCLUSIONS: Acute stent-like angiographic results are obtainable by conventional PTCA in a consistent percentage of eligible coronary lesions. Following a safe modality of balloon-stress application in performing angioplasty, probability of safely achieving OID of coronary stenoses is related to specific angiographic lesion characteristics.
V Di Luzio; F De Remigis; G De Curtis; P Pecce; F Prosperi; A D'Aroma; S Paparoni; L Di Emidio
Related Documents :
2956849 - Late angiographic follow-up after successful coronary arterial thrombolysis and angiopl...
2003519 - Percutaneous transluminal coronary angioplasty in hypothyroidism.
2805319 - Long-term follow-up of ptca of the right coronary artery with shepherd's crook morphology.
1546009 - Chronic stable angina pectoris. risk stratification and treatment.
7586249 - A comparison of the costs of and quality of life after coronary angioplasty or coronary...
2931179 - Cardiac tamponade following percutaneous transluminal coronary angioplasty: four case r...
1458209 - Sonomicrometric studies on the effects of long-term pumping of cardiac assist device on...
11181019 - Pacing redistributes glycogen within the developing myocardium.
2116719 - Management comparison for acute myocardial infarction: direct angioplasty versus sequen...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Giornale italiano di cardiologia     Volume:  28     ISSN:  0046-5968     ISO Abbreviation:  G Ital Cardiol     Publication Date:  1998 Oct 
Date Detail:
Created Date:  1998-12-15     Completed Date:  1998-12-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  1270331     Medline TA:  G Ital Cardiol     Country:  ITALY    
Other Details:
Languages:  eng     Pagination:  1083-93     Citation Subset:  IM    
Department of Cardiology and Cardiac Surgery, Ospedale G.M. Mazzini, Teramo.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary* / adverse effects
Coronary Angiography*
Coronary Disease / radiography*,  therapy*
Middle Aged
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  AI-CARE: a multicentric study on unstable angina. Methodology and preliminary data of a project on t...
Next Document:  New introducer technique for implanting pacemakers and defibrillator leads: percutaneous incannulati...