Minimally invasive angioplasty: acute and long term results of low pressure dilatation with a non-compliant balloon during percutaneous transluminal coronary angioplasty.
Despite technological advances in angioplasty equipment and increased operator experience, the incidence of dissection and abrupt closure remains unchanged.  To test the hypothesis that a different balloon inflation strategy may influence the degree of arterial trauma, and therefore reduce the incidence of major complications, the success rate, acute complications and incidence of restenosis were analyzed in 110 consecutive patients using a non-compliant dilatation catheter. The term "minimally invasive angioplasty" has been coined to describe a strategy of minimizing arterial trauma by using the lowest possible inflation pressures during percutaneous transluminal coronary angioplasty (PTCA).  Lesion analysis using a modified American College of Cardiology/American Heart Association Classification showed that 37% of lesions were Type A, 40% were Type B, and 23% were Type C.  Overall, PTCA success was achieved in 98% of lesions.  Major dissection and abrupt closure occurred in 1%.  No patient required emergency coronary bypass surgery and there were no deaths.  The mean coronary stenosis was reduced from 85% to 18.4%.  In 75% of lesions, inflation pressures of 5 atmospheres (atm) or less were used.  Angiographic follow-up was available in 80 (73%) of the patients and restenosis occurred in 19 (24%).  Thus, minimally invasive angioplasty, a technique which may reduce arterial trauma, results in a high primary success rate; low residual stenosis; and very low incidence of abrupt closure, major dissection and perhaps lower restenosis.  These data suggest the need for further study of PTCA techniques designed to minimize arterial trauma.
Interventional Cardiology Research Institute, Washington Adventist Hospital, Takoma Park, Maryland 20912.
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Shawl
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D000925:Anticoagulants / Q000627:therapeutic use; D003327:Coronary Disease / Q000628:therapy*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011312:Pressure; D012008:Recurrence; D016896:Treatment Outcome