"High-risk" percutaneous transluminal coronary angioplasty.
Of 6,500 percutaneous transluminal coronary angioplasty procedures performed between June 1980 and June 1987, 3,501 (1,604 single lesion and 1,897 multiple lesion) were performed in "low-risk" patients with a procedure-related mortality of 0.2 to 0.3%. In comparison, several clinical variables were identified that increased procedural risk by up to 50-fold. These factors include left main dilatation (n = 103, mortality 3.9%), left main equivalent dilatation (n = 77, mortality 2.6%), ejection fraction less than or equal to 40% (n = 664, mortality 2.7%), age greater than or equal to 70 years (n = 1,038, mortality 1.4%), dilatation of all 3 vessels (n = 305, mortality 1.3%), combined diagnostic catheterization and angioplasty for unstable angina (n = 193, mortality 1.5%), and percutaneous transluminal coronary angioplasty for acute myocardial infarction (n = 446, mortality 8.5%). Important considerations in the selection and management of these high-risk patients are discussed.
Hartzler
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Medical Plaza II-20, Kansas City, Missouri 6411.
Rutherford
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McConahay
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Johnson
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Giorgi
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D000367:Age Factors; D000789:Angina, Unstable / Q000628:therapy; D000800:Angioplasty, Balloon / Q000401:mortality; D003327:Coronary Disease / Q000401:mortality / Q000628:therapy*; D003331:Coronary Vessels; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy; D012307:Risk Factors; D013318:Stroke Volume