Follow-up after successful transluminal angioplasty

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One hundred forty-nine patients underwent percutaneous transluminal coronary angioplasty (PTCA) over a 24-month period. PTCA was successful in 106 patients (71%) and 109 vessels (72%). Patients with primary success were followed for 9 ± 0.6 months (mean ± SEM). Follow-up, ranging from five to 28 months, was based primarily on the evaluation of functional status according to the New York Heart Association Classification. Forty-eight patients underwent repeat coronary angiography during the course of follow-up. Seventy-five patients (71%) experienced continued improvement in functional class at the end of the follow-up period. Sixty-nine patients (65%) were in functional class I at the conclusion of follow-up; 5 of these patients had documented angiographic recurrence, and 12 patients showed no recurrence at repeat angiography. Thirty-one patients (29%) had recurrence of anginal symptoms; 19, 5, and 7 patients were in functional class II, III, and IV, respectively. Of these 31, 14 patients were shown to have no angiographic recurrence, and 13 patients demonstrated recurrent stenosis at repeat angiography. Recurrent symptoms in patients with angiographically documented restenosis of the previously dilated site occurred on an average of 2.7 ± 2.1 months (mean ± SD) post-PTCA. The authors' experience indicates that (a) long-term success is achievable in a substantial majority of PTCA candidates, (b) suspected recurrence must be documented angiographically, and (c) symptomatic recurrences are unusual beyond five months post-PTCA.



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