Very late changes in the dilated lesion following coronary balloon angioplasty: a 17 year serial quantitative angiographic study.
OBJECTIVE
Limited data are available on the changes that occur at the dilated site many years after coronary balloon angioplasty. The development of bioabsorbable stents may increase the importance of understanding the long term changes that occur in an unscaffolded coronary artery following balloon-mediated injury.


RESULTS
This study evaluated, by serial quantitative angiography, the natural history of changes that occurred in the dilated segment between early (mean seven months), late (mean 4.5 years) and very late (mean 17 years) follow-up after balloon angioplasty. Of 127 consecutive patients (174 lesions) with successful coronary angioplasty, 125 underwent early, 84 late and 47 very late angiographic follow-up (75% of eligible survivors). The mean lesion diameter stenosis decreased from 36+/-11% at early to 26+/-15% at late follow-up (p<0.0001), and then increased again to 35+/-25% by very late follow-up (p=0.003). Although stenosis severity at early follow-up angiography predicted lesion regression at late follow-up, there was no significant correlation between late and very late follow-up lesion severity.


CONCLUSIONS
After coronary angioplasty, lesion regression at the dilated site from 7 months to 4.5 years is followed by slow lesion progression over the next 12 years.
Hatrick
Robert I
RI
Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand.
Ormiston
John A
JA
Ruygrok
Peter N
PN
Stewart
James T
JT
Webber
Bruce
B
Gonzales
Hector
H
Webster
Mark W I
MW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging* / Q000209:etiology; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D003331:Coronary Vessels / Q000293:injuries / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome