Usefulness of percutaneous transluminal coronary angioplasty after new device coronary interventions
| Autor: | Robert D. Safian, Gregory Pavlides, Mark Freed, Cindy L. Grines, Anne Lichtenberg, William W. O'Neill, Michelle Strzelecki, Melissa A. May, Theodore L. Schreiber |
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| Rok vydání: | 1994 |
| Předmět: |
Atherectomy
Coronary Angioplasty Balloon Laser-Assisted Percutaneous transluminal coronary angioplasty medicine.medical_specialty medicine.medical_treatment Lumen (anatomy) Coronary Disease Atherectomy Internal medicine medicine Humans New device cardiovascular diseases Myocardial infarction Angioplasty Balloon Coronary Aged Analysis of Variance Chi-Square Distribution Vascular disease business.industry Middle Aged medicine.disease Surgery Stenosis Treatment Outcome surgical procedures operative Bypass surgery Cardiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | The American Journal of Cardiology. 73:642-646 |
| ISSN: | 0002-9149 |
| DOI: | 10.1016/0002-9149(94)90926-1 |
| Popis: | Percutaneous transluminal coronary angioplasty (PTCA) is often required immediately after laser and atherectomy devices to enlarge lumen dimensions and to salvage device failures. Between January 1989 and June 1992, adjunctive PTCA was applied to 83% of narrowings treated with new interventional devices, including 85% of transluminal extraction atherectomy (n = 290), 72% of high-speed mechanical rotational atherectomy (n = 79), and 89% of excimer laser angioplasty (n = 118) lesions (p = NS). Device success was defined as a decrease in diameter stenosis ≥20%; procedural success was defined as a final diameter stenosis ≤ 50% after PTCA; and salvage PTCA was defined as use of PTCA to manage device-induced vessel occlusion. Although adjunctive PTCA was applied to 487 lesions, it was used to further enlarge the lumen after initial device success in 139 lesions (28.5%). In contrast, adjunctive PTCA was used after initial device failure in 348 lesions (71.5%), including after minimal or no change (decrease in diameter stenosis by 0 to 19%) in diameter stenosis in 244 lesions (50%) and after worsening of diameter stenosis in 104 lesions (21.5%). Salvage PTCA after device-induced vessel occlusion was performed in 61 lesions (12.6%). However, final procedural success after PTCA was achieved in 412 lesions (85%), with a low incidence of Q-wave myocardial infarction (3.5%), emergency bypass surgery (1.8%) and death (2.3%). |
| Databáze: | OpenAIRE |
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