Angioplasty of stenoses adjacent to aneurysmal coronary artery disease

We examined the effectiveness and safety of performing angioplasty on stenoses adjacent to aneurysmal coronary artery disease. Out of 386 consecutive lesions (270 patients) on which we performed angioplasty, 13 lesions (13 patients) were within one balloon length of aneurysmal disease (group A) and 373 lesions (257 patients) were not (group NA). Angioplasty had previously been performed on 10 lesions (77%) in group A but only on 112 lesions (30%) in group NA (p less than 0.01). In group A the angioplasty success rate was 100% (13/13). The maximum inflation pressure was 6.5 +/- 1.1 atm, the frequency of inflation was 6.1 +/- 2.8, the average inflation duration was 60 +/- 0 sec, and the balloon/artery ratio was 1.20 +/- 0.11. There were no major complications. Restenosis occurred in only one lesion. There were no significant differences in the angioplasty results, procedures, complications and the incidence of restenosis between both groups. The ratio of the diameter of the aneurysmal disease to the mean diameter of the normal adjacent segments remained unchanged throughout the follow-up period. These data suggest that angioplasty may be an effective and safe treatment for those stenoses that are adjacent to aneurysmal coronary artery disease.