Clinical and angiographic recurrence following PTCA for nonacute total occlusions: comparison of one- versus...

To assess potential efficacy of longer inflations to reduce restenosis, 49 patients with nonacute total occlusions were randomized into two groups after successful guide wire passage across the occlusive stenosis. Twenty-one group I patients had all inflations less than 1 minute, while 28 group II patients received at least one inflation of 5 minutes' duration. There was no significant difference between group I and group II patients in mean age (56 +/- 3 versus 57 +/- 2 years), percent male sex (76% versus 68%), or frequency of left anterior descending (LAD) percutaneous transluminal coronary angioplasty (PTCA) (33% versus 32%), p = NS for all. All lesions post PTCA were less than or equal to 50% stenosed and no patient had coronary artery bypass surgery (CABG). Mean post PTCA stenosis was 29 +/- 2% for group I versus 33 +/- 2% for group II, p = NS. Clinical follow-up was available for all patients 8 +/- 0.6 months after PTCA. Recurrent symptoms were present in 8 of 21 (38%) group I patients compared with 12 of 28 (43%) patients in group II, p = NS. Angiographic follow-up was available in 32 patients (65%), with confirmation of restenosis in seven (33%) group I patients and in 11 (39%) group II patients, p = NS. In conclusion, this prospective study suggests that recurrence rates following successful PTCA of nonacute total occlusions is not modified by 5-minute versus 1-minute inflations.