[Anatomical limitations for the performance of angioplasty in coronary multivessel disease].
OBJECTIVE
To study anatomical limitation of coronary angioplasty, as alternative therapy in patients with multivessel disease and submitted to bypass surgery.


METHODS
In 380 patients with multivessel disease and submitted to previous coronary bypass surgery, age ranged from 41 to 72 (average = 51) years, being 68% males. The following parameters were analyzed in the coronary arteriographies: anatomic aspects of the coronary arteries and distribution of the atherosclerotic stenosis. The patients were arranged in accordance to the criteria: complete revascularization, incomplete and no indication for coronary angioplasty.


RESULTS
The patients were arranged in 3 different groups: I-80 (21%) patients included those in whom complete revascularization would be possible; II--55 (14.5%) patients in whom only incomplete revascularization but satisfactory would be possible and III--245 (65.5%) those patients in whom coronary angioplasty would no have indication. The data referind the patients of groups I and II were analyzed together--135 (35.5%) and arranged according to the number of arteries involved. It was observed: two vessel disease--71.8%, three vessel--18.6% and 4 or more vessel--9.6%. In group III it was observed 51.0% of the patients with 3 or more vessel disease. The major factors to contra indicate coronary angioplasty in group III included: chronic coronary obstruction 99 (40.4%); diffuse disease 11 (4.5%); technical difficulties 10 (4.1%); left main coronary artery obstruction 5 (2%) or when two or more causes were combined 120 (49%).


CONCLUSIONS
Patients with multivessel disease and classic indication for coronary bypass surgery, have a basic limitation for angioplasty due to several anatomic factors. However, coronary angioplasty could be beneficial for a selected group of patients (35.5%) whenever a complete or incomplete revascularization could be obtained.
Pimentel Filho
W A
WA
Hospital Israelita Albert Einstein, SP.
Ascer
E
E
Buchler
J R
JR
de Assis
S F
SF
Hirschfeld
R
R
Soares Neto
M M
MM
Neves
M F
MF
Pinheiro
L F
LF
Araújo
E C
EC
Armelin
E
E
D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon; D000075202:Contraindications; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D012189:Retrospective Studies
Limites anatômicos para a realização de angioplastia na doença coronária multiarterial.