[5 years' experience in complex percutaneous transluminal coronary angioplasty].
We analysed the results of angioplasty done in 117 patients from 1990 to 1995, considering high risk: the following: age over 70 years, ejection fraction lower than 40%, obstruction of anterior descending coronary artery (ADCA) with 100% occlusion of the right coronary artery (RCA) or a dominant circumflex artery (CXA), multivessel lesions B and C, and unstable ischemic syndromes: unstable angina (UA) and acute myocardial infarction (AMI). The mortality in patients older than 70 years (36 patients) was 14% against 7% in those under 70 years (p < 0.05). Mortality in EF (21 under 40% was 33%, higher than patients with EF over 40%, 4.3% (p < 0.01). Patients with obstruction of ADCA and 100% occlusion of RCA or dominant CxA (19), 3(14%) needed coronary revascularization and 4 died from cardiac reasons. In multivessel disease (14) the rate of success depends more on the type of the lesion than on the number. In lesions B and C (54) the dilatation success was 90.3% in B and 50% in C. In UA (29) the ADCA was found compromised in 65% (p < 0.05), early reocclusion was in 4 (13%) and late in 1 (3%), all developed AMI, mortality was 3 (10%). In AMI (21) treated with primary PTCA success was achieved in 15 patients (71.4%).
Kosturakis García
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Departamento de Hemodinamia, Patronato de Enfermedades Cardiovasculares y Cáncer AC, Hospital CIMA, Chihuahua.
D000368:Aged; D000789:Angina, Unstable / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary / Q000706:statistics & numerical data*; D003327:Coronary Disease / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008800:Mexico; D009203:Myocardial Infarction / Q000628:therapy; D012307:Risk Factors; D017211:Treatment Failure