[Mechanical recanalization of chronic coronary artery occlusion by balloon dilatation. Hemodynamic and ventricular kinetic long-term results].
Abundant collaterals may prevent infarction in a region of myocardium supplied by an acutely occluded coronary artery. However, these patients often present with severe angina on exertion which cannot be sufficiently treated with antianginal drugs but require revascularization. Beginning in 1984, recanalization of chronic coronary artery occlusion using balloon catheters was attempted in 48 patients at Medizinische Klinik III, University of Cologne. Interventional therapy was successful in 29/48 patients (60%). The mean diameter narrowing of residual stenoses was 35%. Invasive follow-up at 3 months was possible in 17 of these 29 patients. Restenosis was noted in 41% and reocclusion was found in 18%. In contrast to angiographic findings, clinical symptoms were clearly improved in the majority of cases (88%). This correlates with increased regional contractility of the myocardial region supplied by the previously occluded artery. Contractility was also improved in patients with significant restenosis. The clinical benefit and the improvement of regional myocardial function indicate that it is justified to attempt balloon recanalization in highly symptomatic patients with short distance coronary occlusions despite the relatively high incidence of restenosis and reocclusion.
Kux
A
A
Klinik III für Innere Medizin der Universität zu Köln.
Höpp
H W
HW
Kürten
A
A
Klocke
R K
RK
Pöhler
E
E
Hilger
H H
HH
D015906:Angioplasty, Balloon, Coronary; D001026:Coronary Artery Bypass; D003326:Coronary Circulation / Q000502:physiology; D004562:Electrocardiography / Q000295:instrumentation; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000503:physiopathology; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy*; D012008:Recurrence; D012815:Signal Processing, Computer-Assisted
Mechanische Rekanalisation chronischer Koronararterienverschlüsse durch Ballondilatation. Hämodynamische und ventrikelkinetische Langzeitergebnisse.