Predictors of the rate of success of angioplasty of the left circumflex artery.
Out of 45 angioplasties attempted by the same cardiologist for stenosis of the left circumflex artery at St. Thomas' Hospital in a one and a half year period, six were unsuccessful due to inability to cross the lesion. In four of these cases, the lesion was crossed with the guide wire but not with the balloon. All these failures, and sixteen of the successful cases, were studied by means of geometrical analysis of the anatomy of the circumflex artery and computer-assisted automated quantitation of digital subtraction coronary angiograms obtained at the time of the procedure. The quantitative characteristics of the lesion (the proportional diameter of the stenosis; the proportional geometric area of the stenosis and the proportional densitometric area of the stenosis) were not significantly different between the cases resulting in failure or success. Similarly, the angles of the circumflex artery proximal to the stenosis, the distance of the lesion from the orifice of the artery and the length of the main stem of the left coronary were not different between the two groups. The group in which the angioplasty was unsuccessful had significantly longer lesions, however, whereas the ratios of the diameter (or the geometric area) of the distal part of the vessel beyond the lesion as compared with the proximal (reference) part were significantly lower in the group undergoing successful dilatation. We conclude that neither the angulation of the circumflex artery as it appears on a two-dimensional projection nor the proportional diametric stenosis of the lesion can serve as easily assessible predictors fro the success of the procedure.(ABSTRACT TRUNCATED AT 250 WORDS)
Katritsis
D
D
Department of Cardiology, St. Thomas' Hospital, London, U.K.
Webb-Peploe
M M
MM
D015906:Angioplasty, Balloon, Coronary; D002932:Cineangiography; D003251:Constriction, Pathologic; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000033:anatomy & histology / Q000473:pathology*; D006801:Humans; D008433:Mathematics; D008955:Models, Cardiovascular