title: Coronary angioplasty for chronic total occlusion reduces the need for subsequent coronary bypass surgery.
abstract: Coronary angioplasty was performed in 44 consecutive patients with total occlusion that lasted longer than 1 week. The primary success rate was 59%. Angiographic restudy in 25 of the 26 successful patients (96%) revealed restenosis in 17 patients (65%), which was asymptomatic in seven (44%). Significant correlates of restenosis were mean luminal stenosis at the conclusion of the procedure and symptom recurrence. Clinical follow-up at a mean of 31 +/- 12 months revealed that coronary artery bypass surgery was more frequent in patients who had an unsuccessful initial angioplasty procedure (7/18 vs 3/26; p = 0.04). Nine patients (35%) who had an initially successful procedure required a second angioplasty for symptomatic restenosis. Angioplasty for totally occluded coronary arteries has a high incidence of restenosis that is often asymptomatic. This procedure can, however, lead to a reduction in the need for coronary artery bypass surgery for symptom control.
authors.affiliation: Royal Melbourne Hospital, Victoria, Australia.
authors.forename: R J
authors.initials: RJ
authors.lastname: Warren
authors.forename: A J
authors.initials: AJ
authors.lastname: Black
authors.forename: P A
authors.initials: PA
authors.lastname: Valentine
authors.forename: E G
authors.initials: EG
authors.lastname: Manolas
authors.forename: D
authors.initials: D
authors.lastname: Hunt
mesh_terms: D000792:Angiography; D015906:Angioplasty, Balloon, Coronary; D002908:Chronic Disease; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation