Elective supported angioplasty: initial report of the National Registry

A National Registry of 14 centers performing elective supported angioplasty was formed to collate the initial experience with high-risk patients. Suggested indications were ejection fraction less than 25% and/or target vessels supplying greater than half of the viable myocardium. The data from 105 patients were entered into the Registry during 1988. This group included 30 patients who had dilation of their only patent coronary vessel and 20 patients whose disease was deemed too severe to undergo bypass surgery. Chest pain and ECG changes were uncommonly experienced during balloon inflation. The group experienced a high angioplasty success rate (95%) with an average of 1.7 dilatations per patient. Morbidity was frequently experienced, the majority of which was associated with cannula (18-20F) placement and/or removal. The overall hospital mortality was 7.6%, although half of the deaths occurred in patients who were both over 75 years of age and had left main coronary artery stenosis. Patients under the age of 75 years without left main coronary artery stenosis experienced a hospital mortality rate of 2.6%. Symptomatic improvement occurred in 91% of the patients surviving hospitalization. During the follow-up period of 1-12 months, three patients died of cardiac complications. This multicenter experience suggests that supported angioplasty can be performed safely in high-risk patients in several high-risk subgroups with the expectation of good symptomatic improvement and short-term survival.