The occurrence of early sudden coronary artery occlusion following angioplasty may be predicted from the clinical characteristics of the patients and their coronary lesion morphology.
The aim of this study was to assess whether the incidence of early occlusion following angioplasty was greater among patients with unstable angina and whether the coronary lesions prone to early occlusion could be predicted from their angiographic appearance. Seventy-seven patients who had had a first angioplasty of a native vessel for stable or unstable angina in one twelve month period were included. The angiographic appearances of the angioplastied lesions were classified as either Type 1, which were smooth and unlikely to have thrombus or intimal rupture, or Type 2, which were irregular due to thrombus or intimal rupture. The lesion classification was compared to the patients' clinical features, i.e. stable or unstable angina, and the outcome of the angioplasty. Type 2 lesions occurred in 25% of patients with stable angina but 49% of patients with unstable angina (p less than 0.05). Early sudden occlusion of the angioplastied vessel occurred in 24% of patients with unstable angina but in only 3% of patients with stable angina (p less than 0.05) and in 6% of Type 1 lesions compared with 24% of Type 2 lesions (p less than 0.05). Thus it is possible to identify the clinical characteristics and angiographic appearances of those patients undergoing angioplasty who are most likely to experience early vessel occlusion.
Buchalter
M B
MB
Department of Cardiology, University of Newcastle-upon-Tyne, England.
Been
M
M
Williams
D O
DO
Adams
P C
PC
Reid
D S
DS
D000787:Angina Pectoris / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy; D000789:Angina, Unstable / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D006801:Humans; D015994:Incidence; D011379:Prognosis; D012008:Recurrence; D015203:Reproducibility of Results