Does a waiting time for elective coronary angioplasty affect the primary success rate?
OBJECTIVE
To evaluate the effect of the waiting time for elective percutaneous transluminal coronary angioplasty (PTCA) on the primary success rate.


METHODS
University hospital in The Netherlands.


METHODS
A cohort of 817 consecutive patients awaiting elective PTCA. Scheduled PTCA was performed in all 817 patients, involving 1237 coronary lesions.


METHODS
The relation between procedural success and the duration of the waiting time was evaluated. Major cardiac events, that is, death and myocardial infarction while awaiting PTCA, were documented. Alterations in lesion characteristics during the waiting time were assessed in unsuccessful procedures.


RESULTS
Elective PTCA was performed within one to six weeks after acceptance in 388 patients (587 lesions; 47.5%), between six and 12 weeks in 203 patients (308 lesions; 25%), and after more than 12 weeks in 226 patients (342 lesions; 27.5%). The procedural success rates in the defined time intervals were 97%, 99%, and 97% in ACC/AHA type A lesions, 93%, 87% and 90% in type B lesions, and 63%, 55% and 38% in type C lesions respectively; 96% of type C lesions were total coronary occlusions. There was a significant decrease in primary success rate in type C lesions after a waiting time beyond 12 weeks. A reasonable explanation for an unsuccessful angioplasty related to alterations in lesion characteristics during the waiting time was documented in only four of 115 procedures.


CONCLUSIONS
The primary success in type A and B lesions is unaffected by the duration of a waiting period for elective PTCA. A waiting time of more than 12 weeks is associated with a lower success rate in patients with total coronary occlusions.
Koch
K T
KT
Department of Cardiology, University of Amsterdam, The Netherlands.
Piek
J J
JJ
David
G K
GK
Mulder
K
K
Peters
R J
RJ
Lie
K I
KI
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003327:Coronary Disease / Q000628:therapy*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome; D014850:Waiting Lists