Treatment of Diffuse Coronary Artery and Vein Graft Disease With a 60-mm-Long Balloon: Early Clinical Experience

To report our preliminary clinical experience with a new 60-mm-long angioplasty balloon. Design: We reviewed the results in patients who underwent this type of angioplasty between May and October 1993 at our institution. The study group consisted of 14 high-risk patients (57% with rest-related angina) and 19 treated coronary segments—52% in native coronary arteries and 48 % in saphenous vein grafts (mean age, 9 years). Often, long balloon angioplasty was used in conjunction with laser or transluminal extraction atherectomy. Angiographic success (40% or more visual reduction in diameter stenosis) was achieved in all patients. Intimal dissection occurred in 4 of the 19 treated segments (21 %), but each was less than 50% obstructive. No patient required intracoronary stenting. Clinical success was achieved in 13 patients (93%). The one death that occurred was from vein graft distal embolization. At a mean follow-up of 9 months, three patients had required reinterventional procedures, and one patient had undergone a coronary artery bypass operation. No myocardial infarction or death occurred during this period. Preliminary clinical experience with a 60-mm-long angioplasty balloon to treat complicated coronary lesions in high-risk patients suggests that, when used alone or in combination with other devices, this new balloon results in high initial success and low complication rates. A larger clinical experience is necessary for accurate assessment of the role of this new balloon catheter.