Coronary angioplasty in stenotic lesions adjacent to coronary aneurysms.
The efficacy and safety of coronary angioplasty for stenoses adjacent to coronary aneurysms were studied in 25 patients (19 men and 6 women, mean age 62 +/- 11 years).  The study represented 1.1% of patients undergoing coronary angioplasty during the study time period.  The aneurysm diameter exceeded 1.8 +/- 0.2 times the normal artery diameter.  Eleven (44%) of these aneurysms were localized in the left anterior descending, 3 (12%) in the circumflex and 11 (44%) in the right coronary artery. Percent diameter stenosis was reduced from 72 +/- 10% to 23 +/- 19%, and transstenotic gradient from 51 +/- 13 to 15 +/- 9 mmHg when measured.  Clinical success (absence of pain on discharge without coronary bypass surgery, death, or infarction) was achieved in 24 (96%) patients.  In one patient acute vessel closure occurred.  No embolic events or coronary artery rupture occurred.  Seventeen (71%) of the 24 successful patients remained asymptomatic at clinical follow-up (mean = 7.7 +/- 5.0 months).  At late follow-up, one patient had sustained a myocardial infarction, two had elective bypass surgery, and two had successful repeat angioplasty.  The data from this small patient population suggest that angioplasty for a stenosis adjacent to a coronary aneurysm can be performed safely with a high primary success rate.
Minneapolis Heart Institute/Abbott Northwestern Hospital, MN 55407.
M
M
Brack
J F
JF
Mooney
M
M
Huber
F L
FL
Gobel
R A
RA
Van Tassel
M R
MR
Mooney
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods*; D003323:Coronary Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging; D017023:Coronary Angiography; D003327:Coronary Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D004869:Equipment Safety; D005069:Evaluation Studies as Topic; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies