[Long-term success of coronary angioplasty after repeated treatment].
To ascertain the long-term results after second and third angioplasties for coronary stenosis the coronary angiograms from 1504 consecutive patients with coronary heart disease (1211 men, 293 women, mean age 57 [27-82] years) were retrospectively surveyed. A good initial response (at least 20% reduction in stenosis) was achieved in 295 out of 306 second angioplasties (95.5%), and in all 36 third angioplasties. Viewed overall, these results are significantly better (P less than 0.005) than those achieved at the initial angioplasty (1386 out of 1504 patients; 92.2%). The reduction in the severity of the stenosis achieved at the second angioplasty (from 86 to 24%) and at the third angioplasty (from 86 to 26%) was the same as at the first angioplasty (from 88 to 28%). Serious complications after the first angioplasty were infrequent (death in 0.2%, emergency bypass in 0.4%, myocardial infarction in 0.5%), and no complications were noted after second and third angioplasties. A good long-term outcome (at least 20% reduction in stenosis at 3-4 months) was slightly more frequent after the second and third angioplasties (103 out of 170 [60.6%] and 14 out of 17 patients, respectively) than after the first intervention (532 out of 926 patients; 57.5%). In keeping with these results, the degree of stenosis found at follow-up angiography was significantly lower (first intervention 54.8%, second intervention 50.3%, third intervention 36.9%). There were only 57 patients (3.8%) who ultimately required operative treatment. These figures indicate that the probability of a good long-term outcome from coronary angioplasty increases each time the stretching operation is repeated. Only a very small proportion of patients will require bypass surgery.
Schwarz
F
F
Abteilung Kardiologie, Rotes-Kreuz-Krankenhaus Frankfurt/Main.
Störger
H
H
Preusler
W
W
Reifart
N
N
Baier
T
T
Schlotzer
P
P
Neubauer
A
A
Heinsen
S
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003327:Coronary Disease / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies
Langzeiterfolg der Koronarangioplastie nach wiederholten Eingriffen.