Outcome in patients with recurrent restenosis after percutaneous transluminal balloon angioplasty.
The records of 1162 consecutive patients undergoing their first percutaneous transluminal coronary angioplasty at a centre between March 1980 and June 1987 were reviewed. Initial angioplasty was successful in 1011 patients (87%). In 202 (20%) symptomatic restenosis developed. Of these, 196 were treated with redilatation; this was successful in 181 (92%). After a second dilatation, restenosis developed in 47 patients (26%). Of these, 41 (87%) were treated with a third angioplasty, with primary success in 38 (93%). A further restenosis developed in 13 of these 38 patients (34%). Eight patients were treated with a fourth angioplasty with restenosis in four (50%). Two of these four patients underwent a fifth angioplasty (with continuing success at long term follow up in both). Overall, 14 of the 47 (30%) patients who developed restenosis twice were eventually treated with coronary bypass surgery. Most patients (33), however, were treated only with repeated angioplasties. Of these 33 patients, 27 were treated with a third angioplasty, four with a fourth procedure, and two with a fifth. Twenty-nine (88%) were symptom free at a mean follow up of 28 (range 8 to 86) months. The combined success rate for a third, fourth, and fifth angioplasty was 94%. These data suggest that most patients with recurrent restenosis after angioplasty may be managed successfully and safely with repeated redilatations.
Glazier
J J
JJ
Evans Memorial Department of Clinical Research, Boston University Medical Centre, Massachusetts.
Varricchione
T R
TR
Ryan
T J
TJ
Ruocco
N A
NA
Jacobs
A K
AK
Faxon
D P
DP
D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000209:etiology; D000800:Angioplasty, Balloon / Q000706:statistics & numerical data; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011379:Prognosis; D012008:Recurrence