Percutaneous transluminal coronary angioplasty; two years' experience

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Since September 1977,1, 2 82 patients (July 1979) with various lesions have undergone percutaneous transluminal coronary angioplasty. The age range was 31 to 68 years. Forty-five patients had single-vessel disease (no other major artery involved with more than 50% obstruction), eight had status after aortocoronary bypass operation with recurrent stenosis and symptoms, and the remainder had double- or triple-vessel involvement.

Patients have been studied by clinical status, exercise tests, and coronary angiography before and after percutaneous transluminal coronary angioplasty, including follow-up every 3 months for the first year and angiography repeated 6 to 9 months thereafter.

In 68 patients (83%) we were able to pass the lesion with the dilatation catheter. In this group the mean duration of angina pectoris since the onset of chest pain had been 9 months (range, 1 to 108 months).

In 60 cases anatomical and hemodynamic success could be noted, which led to significant improvement in clinical parameters, e.g., reduction of coronary narrowing of the transluminal diameter from 82% ± 11% (mean ± 1 SD) to 34% ± 16% (p < 0.001). The stenosis is calculated as a mean of at least three oblique projections.

The mean pressure gradient across the stenosis was measured through the main lumen of the double lumen dilatation catheter. As a result of dilatation the mean pressure gradient across the lesion was reduced from 56 ± 15 mm Hg to 19 ± 12 mm Hg (p < 0.001).

The improvement of anatomy and distal coronary pressure led to an increase . . .



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