Angioplasty of the proximal left anterior descending artery outside the acute phase of myocardial infarction. Apropos of a series of 100 consecutive patients
Maillard, J.M.; Paemelaere, B.; Desveaux, D.; Olinic, L.; Quilliet, X.; Moini, C.; Hudelo, P.; Charbonnier, B.; Raynaud, P.
Archives des Maladies du Coeur et des Vaisseaux 89(7): 825-833
1996
ISSN/ISBN: 0003-9683 PMID: 8869243 Document Number: 457817
The indications of percutaneous transluminal coronary angioplasty (PTCA) of the proximal left anterior descending artery (LAD 1) must take into consideration the importance of the threatened myocardial territory in case of complications and the supposedly increased risk of restenosis of this arterial segment. One hundred consecutive patients (average age 59.9 +/- 11.4 years with 77% of men) outside the acute phase of myocardial infarction were included in this retrospective open study from January 1st 1988 to March 1st 1992. There were 76 cases of single vessel. The average left ventricular ejection fraction was 64.8 +/- 12%. During the hospital period, there were no deaths. 1 myocardial infarction despite emergency coronary bypass surgery, and 2 programmed coronary bypass procedures. During follow-up, "clinical restenosis" as defined by the authors was observed in 29.7% of cases; 1 patient died of cardiovascular causes, 18 had a repeat PTCA with a success rate of 100%. The clinical restenosis rate of repeat PTCA was 33%. One patient underwent a third PTCA with a successful outcome. Ten coronary bypass procedures were necessary. Restenosis was more common after PTCA of lesions situated on a bifurcation and when high inflation pressures had to be used. Restenosis was constant after repeat PTCA when the initial restenosis occurred before the 60th day.