[Long-term outcome of dilated or stented segments]

Coronary angioplasty with a balloon catheter or stent should be shown to prolong life and improve its quality. Many clinical and angiographic studies have provided information on the long-term outcome of dilated or stented segments. In general, a lesion treated by balloon or stent which has not restenosed within 6 months has a good long-term prognosis. The compensatory widening and arterial remodelling of the dilated segments seem to be the determining factors whereas intimal hyperplasia may be reduced by a decrease in the cellular components of stented segments. The recurrence of coronary events is more usually related to progression of the coronary artery disease than to deterioration of the dilated or stented segments. However, these general concepts should be modulated with respect to local (lesion-dependant) or general (patient-dependant) factors. The properties of the lesion (type, site), the diffusion of the atherosclerosis, partial primary result of angioplasty and associated diabetes, coronary bypass grafting, unstable angina and left ventricular dysfunction are the prognostic factors of long-term coronary outcome.