5 years' experience in complex percutaneous transluminal coronary angioplasty
Kosturakis García, D.
Archivos del Instituto de Cardiologia de Mexico 68(2): 140-146
1998
ISSN/ISBN: 0020-3785 PMID: 9810357 Document Number: 495954
We analysed the results of angioplasty done in 117 patients from 1990 to 1995, considering high risk: the following: age over 70 years, ejection fraction lower than 40%, obstruction of anterior descending coronary artery (ADCA) with 100% occlusion of the right coronary artery (RCA) or a dominant circumflex artery (CXA), multivessel lesions B and C, and unstable ischemic syndromes: unstable angina (UA) and acute myocardial infarction (AMI). The mortality in patients older than 70 years (36 patients) was 14% against 7% in those under 70 years (p < 0.05). Mortality in EF (21 under 40% was 33%, higher than patients with EF over 40%, 4.3% (p < 0.01). Patients with obstruction of ADCA and 100% occlusion of RCA or dominant CxA (19), 3(14%) needed coronary revascularization and 4 died from cardiac reasons. In multivessel disease (14) the rate of success depends more on the type of the lesion than on the number. In lesions B and C (54) the dilatation success was 90.3% in B and 50% in C. In UA (29) the ADCA was found compromised in 65% (p < 0.05), early reocclusion was in 4 (13%) and late in 1 (3%), all developed AMI, mortality was 3 (10%). In AMI (21) treated with primary PTCA success was achieved in 15 patients (71.4%).