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Staged Approach to Multivessel Coronary Angioplasty: Strategic Considerations and Results

Staged Approach to Multivessel Coronary Angioplasty: Strategic Considerations and Results PTCA was performed in separate sessions in 104 (24%) of the first 439 patients who had multivessel PTCA in our institution. There were 78 men and 26 women, mean age 58 years; 37patients (36%) had triple vessel coronary artery disease, 11 patients (10%) had prior CABG, 58 patients (56%) had unstable angina and 35 patients (34%) had recent MI (< 15 days): 14 of these (13%) had intravenous thrombolysis: ± 3 days before PTCA. Indications for staging were recent MI (28%), long procedure (22%), split or tear of first vessel(s) (22%), large number of lesions dilated (20%), pre‐PTCA complex lesions (8%). PTCA was done in 272 vessels (2.6/pt, range 2–6/pt) and in 385 lesions (3.7/pt, range 2–12/pt) with angiographic success in 262 vessels (96%) and 374 lesions (97%); angiographic success in all lesions attempted was obtained in 91% of patients and clinical success in 102 patients (98%). Complication rate was 3.8%: four patients (3.8%) had MI, no patients had urgent CABG. In comparison, significant differences were present in the 335 patients who had multivessel PTCA at one sitting: three vessel CAD was less frequent (22%, p < 0.05), recent MI was less frequent (18%), p < 0.01; the number of lesions dilated/patient was significantly lower (2.7/pt vs 3.7/pts, p < 0.001) and so was the number of total occlusions attempted (18% vs 31%, p < 0.02). Success in all lesions was achieved in 82% of these patients, p < 0.05; clinical success was similar (96%), with a 6.9% total complication rate (p < 0.07) (17 patients (5%) had MI, nine patients (2.7%) required urgent CABG). Thus, staged multivessel PTCA is an effective strategy and may allow more extensive and safer dilatations in selected patients. (J Interven Cardiol 1988:1:3) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Interventional Cardiology Wiley

Staged Approach to Multivessel Coronary Angioplasty: Strategic Considerations and Results

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References (6)

Publisher
Wiley
Copyright
Copyright © 1988 Wiley Subscription Services, Inc., A Wiley Company
ISSN
0896-4327
eISSN
1540-8183
DOI
10.1111/j.1540-8183.1988.tb00404.x
Publisher site
See Article on Publisher Site

Abstract

PTCA was performed in separate sessions in 104 (24%) of the first 439 patients who had multivessel PTCA in our institution. There were 78 men and 26 women, mean age 58 years; 37patients (36%) had triple vessel coronary artery disease, 11 patients (10%) had prior CABG, 58 patients (56%) had unstable angina and 35 patients (34%) had recent MI (< 15 days): 14 of these (13%) had intravenous thrombolysis: ± 3 days before PTCA. Indications for staging were recent MI (28%), long procedure (22%), split or tear of first vessel(s) (22%), large number of lesions dilated (20%), pre‐PTCA complex lesions (8%). PTCA was done in 272 vessels (2.6/pt, range 2–6/pt) and in 385 lesions (3.7/pt, range 2–12/pt) with angiographic success in 262 vessels (96%) and 374 lesions (97%); angiographic success in all lesions attempted was obtained in 91% of patients and clinical success in 102 patients (98%). Complication rate was 3.8%: four patients (3.8%) had MI, no patients had urgent CABG. In comparison, significant differences were present in the 335 patients who had multivessel PTCA at one sitting: three vessel CAD was less frequent (22%, p < 0.05), recent MI was less frequent (18%), p < 0.01; the number of lesions dilated/patient was significantly lower (2.7/pt vs 3.7/pts, p < 0.001) and so was the number of total occlusions attempted (18% vs 31%, p < 0.02). Success in all lesions was achieved in 82% of these patients, p < 0.05; clinical success was similar (96%), with a 6.9% total complication rate (p < 0.07) (17 patients (5%) had MI, nine patients (2.7%) required urgent CABG). Thus, staged multivessel PTCA is an effective strategy and may allow more extensive and safer dilatations in selected patients. (J Interven Cardiol 1988:1:3)

Journal

Journal of Interventional Cardiology – Wiley

Published: Sep 1, 1988

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