Document Detail


Percutaneous transluminal coronary angioplasty in multivessel coronary disease patients: short- and long-term follow-up in single and multiple dilatations.
MedLine Citation:
PMID:  2976329     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Transluminal coronary angioplasty was successfully performed in 658 of 752 patients with multivessel disease. An angiographic success was achieved in 1198 of 1358 lesions (88%). One lesion was attempted in 338 patients (45%); 2 in 273 (37%); 3, in 101 (13%); and, 4 or more in 40 cases (5.3%). Significant complications occurred in 39 patients (5.2%): 19 (2.5%) had a transmural infarction; 26 (3.5%) required urgent myocardial revascularization; and 14 (1.9%) died. An apparent lesion recurrence occurred in 233 of 658 (35%) patients with 162 of 171 (95%) having a successful second coronary angioplasty. A second apparent lesion recurrence occurred in 37 of 162 patients (23%) with 24 of 28 (86%) having a successful third coronary angioplasty. Clinical improvement (mean follow-up: 31 +/- 17 months) persisted in 81% of successful patients. The cumulative probability of survival was 91.5% at 72 months. Survival was adversely affected, at 63 months, by the presence of prior bypass surgery (no prior bypass surgery, 94% vs. prior bypass surgery, 86%; p less than 0.05): at 24 months by a low left ventricular ejection fraction (less than or equal to 35%, 82% vs. left ventricular ejection fraction greater than 35%, 95%; p less than 0.01) and, at 57 months, in the multiple dilatation group with prior bypass surgery (no bypass surgery 96% vs. prior bypass surgery 84%; p less than 0.05). Multiple dilatation had a beneficial effect upon survival, at 27 months, in patients with a left ventricular ejection fraction less than or equal to 35% [single dilatation, 74% vs. multiple dilatation, 93%; p less than 0.001], and in patients greater than or equal to 70 years, at 39 months (79% vs. multiple dilatation, 92%; p less than 0.01). These data suggest that coronary angioplasty can be an effective treatment in patients with multivessel coronary disease without the need to dilate all diseased vessels, with good success, acceptable complication rates, and a reasonable expectation of satisfactory long-term clinical improvement.
Authors:
G Dorros; R F Lewin; L M Mathiak
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical cardiology     Volume:  11     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  1988 Sep 
Date Detail:
Created Date:  1989-04-19     Completed Date:  1989-04-19     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  601-12     Citation Subset:  IM    
Affiliation:
Department of Cardiology St. Luke's Medical Center, Milwaukee, Wisconsin.
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MeSH Terms
Descriptor/Qualifier:
Actuarial Analysis
Aged
Angina Pectoris / therapy
Angioplasty, Balloon* / adverse effects
Coronary Disease / therapy*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Prospective Studies

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


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