Coronary angioplasty: results with expanded indications

We reviewed 600 consecutive percutaneous transluminal coronary angioplasty procedures in 530 patients. There were 475 men (89%) and 55 women (11%) with a mean age of 55±9 years. Primary success per patient was 87%. Major acute complications occurred in 58 patients (10%): 2 deaths, vessel or side branch occlusion in 44 patients and ventricular fibrillation in 12 patients. Clinical follow-up was available in 344 of the first 348 patients (99%) at 12±6 months. Of these, 242 patients (70%) underwent control angiography at 12±6 months. Including repeat angioplasty, 82% of patients ( 281 344 ) with primary success were improved by at least one New York Heart Association functional class. Coronary events among the patients with no improvement were one sudden death, one myocardial infarction, and 16 bypass operations. Four subgroups of special interest were analysed: multivessel angioplasty (100 patients), angioplasty for chronic total occulusion (100 patients), angioplasty for evolving myocardial infarction (50 patients), and repeat coronary angioplasty (70 patients). Primary success rates were 87, 56, 84 and 90%, complication rates 9, 0, 9, and 3%, and recurrence rates 41, 48, 23, and 48%, respectively. At follow-up, improvement by at least one New York Heart Association class was observed in 77, 85, 88, and 80% of patients, respectively. Successful coronary angioplasty including repeat procedures achieved a long-term clinical success in about 80% of patients.