[Comparative study of short and medium-term results of angioplasty and bypass in severe or unstable angina pectoris caused by isolated stenosis of the anterior interventricular branch].
This retrospective non-randomized study deals with 146 patients subjected to revascularization procedures for severe or instable angina pectoris due to isolated stenosis of proximal or middle anterior interventricular artery, without myocardial infarction in the anamnesis. The patients were divided into two comparable groups: group A (74 patients) treated by an aorto-coronary bypass saphenous vein graft; group B (63 patients) subjected to transluminal coronary angioplasty. None of them presented an associated cardiopathy. The patients were controlled after 10.4 months (group A) and 9.1 months (group B); a physical stress-testing was performed according to the same protocol in the two groups, and control coronarography in group B. The evolution was characterized by one death in each group and a more frequent incidence of infarction (6.7%) in group A than in group B (2.7%, p = NS). The symptomatology in both groups was comparable: 12.1% in group A and 9.1% in group B was free of symptoms. Also the stress-testing yielded similar results: a negative and maximal in 43.6% in group A and 56.4% in group B. When positive at the control (in 27% of group A and 36% of group B) the threshold of appearance of ischemia was delayed only in group B. Thus even if the functional results are comparable in the two groups, the risk of infarction is less after angioplasty, in return, however, for 23% of recurrent stenoses.
D000328:Adult; D000787:Angina Pectoris / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D000789:Angina, Unstable / Q000209:etiology / Q000601:surgery / Q000628:therapy; D000800:Angioplasty, Balloon; D001026:Coronary Artery Bypass / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012306:Risk; D013997:Time Factors
Etude comparative des résultats à court et moyen terme de l'angioplastie et du pontage dans l'angor sévère ou instable par sténose isolée de l'IVA.