[Repeat coronary angioplasty in the treatment of restenosis. Results and follow-up].
With the aim of assessing the value of repeat angioplasty in the treatment of coronary restenosis we have compared the clinical, hemodynamic and procedural variables of 404 consecutive angioplasties, where 468 original lesions were treated, with 57 repeat angioplasties with 63 restenosed lesions attempted. The procedure was performed in the treatment of a myocardial infarction only in the group with original lesions (13% vs 0%, p less than 0.05). The hemodynamic variables including ejection fraction (63 +/- 14 vs 67 +/- 15) and the presence of multivessel disease (38% vs 41%) were similar in both groups, but more angioplasties in the restenosed group were performed in the left anterior descending coronary artery (70% vs 50%, p less than 0.01) whereas less were performed in the circumflex artery (6% vs 19%, p less than 0.05). Long lesions (greater than or equal to 12 mm), and concentric lesions, were more frequently found in the group with restenosis (33% vs 16%, p less than 0.05, and 48% vs 32%, p less than 0.05, respectively). In addition, more angioplasties in the restenosed group were performed during the diagnostic coronary angiogram (68% vs 24%, p less than 0.001). The results both per lesion (98% vs 88%, p less than 0.05) and per procedure (96% vs 86%, p less than 0.05) were better in the restenosed group, with a similar rate of major complications (2% vs 4%). With an angiographic follow-up higher than 90%, the restenosis rate was again similar in both groups (36% and 35%). We conclude that repeat angioplasty is an effective means of treating coronary restenosis with a higher success than the original procedure, probably reflecting an anatomic substrate more prone to be successfully dilated in the restenosed lesion. Accordingly, we are using repeat angioplasty as the treatment of choice for symptomatic restenosis.
Alfonso
F
F
Macaya
C
C
Iñiguez
A
A
Zarco
P
P
D000800:Angioplasty, Balloon; D015331:Cohort Studies; D003251:Constriction, Pathologic / Q000503:physiopathology / Q000628:therapy; D003327:Coronary Disease / Q000503:physiopathology / Q000628:therapy*; D005500:Follow-Up Studies; D006439:Hemodynamics; D006801:Humans; D011446:Prospective Studies; D012008:Recurrence
La angioplastia coronaria repetida en el tratamiento de la reestenosis. Resultados y seguimiento.