Coronary dissection: a predictor of restenosis?
To determine if arterial dissection resulting from transluminal coronary angioplasty (TCA) leads to a greater incidence of restenosis, 273 consecutive patients who had undergone TCA with at least 1 year of follow-up were examined. Success was graded as a greater than or equal to 20% increase in intraluminal diameter. Dissection was defined as a prominent intimal defect at the site of angioplasty. Restenosis was defined as a 50% loss of the initial angiographic gain. Of 216 patients in whom TCA was successful, 64 (30%) had dissections at the site of angioplasty and 152 (70%) had no dissection. During follow-up, 135 patients were asymptomatic with normal results of exercise tolerance tests, recurrent symptoms developed in 81 patients, and 64 patients underwent repeat angiography. The overall restenosis rate was 21%. In the dissection group, 11 (18%) had documented restenosis and 49 (82%) did not develop restenosis. In the nondissection group, 35 (24%) had documented restenosis and 113 (76%) did not develop restenosis. These data show that patients who develop dissections at the time of TCA are no more likely to develop restenosis during follow-up.
Matthews
B J
BJ
Department of Medicine, Georgetown University Medical Center, Washington, DC 20007.
Ewels
C J
CJ
Kent
K M
KM
D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000628:therapy*; D003331:Coronary Vessels / Q000293:injuries*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012737:Sex Factors; D014945:Wound Healing