Changing patterns in percutaneous transluminal coronary angioplasty.
We analyzed the impact of evolving technology on percutaneous transluminal coronary angioplasty in 2677 patients. There were 168 patients in period 1 when fixed-wire catheters were used, 1117 patients in period 2 when steerable catheters were available, and 1392 patients in period 3 when low-profile systems were utilized. The age of patients (55 to 57 to 59 years) and the proportion of patients with severe angina increased over the three periods (25% to 36% to 54%). The percentage of high-grade stenosis and the proportion of distal lesions also increased. Primary success rate improved from 73% in period 1 to 94% in periods 2 and 3. Emergency bypass surgery decreased (8.3% to 4.2% to 2.5%), as did the incidence of myocardial infarction (7.1% to 3.3% to 2.4%). Mortality was 0% in period 1, 0.2% in period 2, and 0.4% in period 3. These results indicate that technological advancements and increased operator experience significantly improved the primary success rate and decreased the incidence of major complications.
Tuzcu
E M
EM
Department of Cardiology, Cleveland Clinic Foundation, OH 44195.
Simpfendorfer
C
C
Dorosti
K
K
Franco
I
I
Hollman
J
J
Badhwar
K
K
Whitlow
P
P
D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000706:statistics & numerical data; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged