Percutaneous transluminal coronary angioplasty of occluded coronary arteries. New angiographic features related to success.
Percutaneous transluminal coronary angioplasty of coronary artery occlusions forms a routine part of cardiological practice. However, only a few angiographic variables which might predict success have been investigated and identified. Video densitometry was used to assess structural features of the occlusion that have not been investigated previously. The sharpness and eccentricity of the tapering, the presence of any distal vessel and the presence of a reservoir or atrium in which the end of the wire could become trapped were measured. Other measurements taken from the cineangiogram included the minimum radius of curvature of the artery immediately before the occlusion, the number of bends and the distance traversed before the occlusion. The number, size, location and angle of branching of side branches from the artery in question were noted. The number of bridging collaterals and presence of distal opacification were noted. There was a significantly higher success rate in patients with less than 3 bends before the occlusion (p = 0.01) and a distance down the artery to the occlusion of less than 27 mm (p < 0.05). An atrium was present in 36% and was associated with an unsuccessful outcome (p = 0.02). Distal opacification, despite occlusion of the artery, was found to be associated with failure to cross the lesion (p < 0.05). The angle of branches of the artery was only found to be important near (within 7.5 mm) the occlusion (p < 0.05). None of the video densitometric measurements of the fine structure of the stump of the coronary artery were found to be helpful.
Horner
S M
SM
Department of Cardiology, Middlesex Hospital, London, England.
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000628:therapy; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D011379:Prognosis