Recurrence of stenosis after first and repeat coronary angioplasty. Clinical and angiographic follow-up.
The incidence of restenosis after initially successful first coronary angioplasty and the long-term effectiveness of repeat angioplasty for recurrence were examined on the basis of data on 282 consecutive patients with successful angioplasty. Primary success of first coronary angioplasty was obtained in 86% of patients and major complications (death, acute myocardial infarction and emergency coronary bypass surgery) occurred in 5% of patients. Control coronary angiography 10 +/- 6 months after successful angioplasty in 195 patients documented recurrence of stenosis in 33%. Repeat angioplasty was attempted in 52 patients with a primary success of 92%. One patient sustained an acute infarction as a complication of the procedure (2%). Control coronary angiography 7 +/- 4 months after a successful second procedure in 28 patients documented a second recurrence of stenosis in 39%. Recurrence rates after first and second coronary angioplasty were comparable (33 vs 39%, ns) but, for lesions of the left anterior descending coronary artery, recurrence was observed more frequently after second than after first angioplasty (47 vs 31%, p less than 0.05). Restenosis after second angioplasty, but not after first, was more frequent in women than in men. Patients with second recurrence were older than those with continuing angiographic success (59 +/- 8 vs 50 +/- 12 years, p less than 0.05). Recurrence was treated by a third coronary angioplasty in 5 patients, with success in all. Clinical follow-up 8 +/- 6 months after the last successful procedure was available for all 43 patients with repeat angioplasty who did not cross over to coronary surgery.(ABSTRACT TRUNCATED AT 250 WORDS)
D000368:Aged; D000792:Angiography; D000800:Angioplasty, Balloon / Q000009:adverse effects; D003327:Coronary Disease / Q000601:surgery / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies