The role of the surgeon in percutaneous transluminal dilation of coronary stenosis.
Percutaneous transluminal dilation (PTD) of coronary artery stenosis is performed by means of a balloon-tipped catheter introduced from a peripheral artery. It was attempted in 45 patients; stenosis was passed in 33 and was successfully dilated in 28 patients (62%). The method failed in 17 patients: in 6 of them an abrupt closure of a stenosed artery or a beginning infarction necessitated an emergency revascularization. There were no deaths or serious complications, but an infarction developed in 1 patient despite immediate bypass grafting. PTD was successful in 5 out of 7 patients who had recurrent angina after previous coronary bypass grafting: in 2 of them stenosis of a distal coronary artery and in 3 a stenosed bypass graft were dilated. PTD is a new method of treatment of coronary artery disease and is an addition rather than an alternative to coronary bypass grafting. The best results can be expected in patients with single-vessel disease, with a short history of angina (less than 1 year), and with narrow, noncalcified proximal stenosis. Some late complications of bypass grafting are also amenable to this method of treatment.
D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000601:surgery / Q000628:therapy*; D004106:Dilatation / Q000009:adverse effects; D005260:Female; D013502:General Surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D010819:Physician's Role; D012380:Role; D012501:Saphenous Vein / Q000637:transplantation; D014182:Transplantation, Autologous