Care of the patient after coronary angioplasty

Because coronary angioplasty is being increasingly used as a treatment for coronary artery disease, the proper evaluation and management of patients after the procedure are important issues. Although coronary angioplasty is a complex technical procedure, the methods routinely used to evaluate its results have many shortcomings. Although the initial results of the procedure are assessed most commonly by the visual interpretation of video images and coronary angiograms, quantitative angiography, trans-stenotic pressure gradients, and coronary flow reserve measurements have also been used. In the period after coronary angioplasty, success can be evaluated by patients' clinical improvement in symptoms and their stress responses to various functional tests. The management of the patient during the first 24 hours after angioplasty should focus on the prevention, detection, and, if necessary, treatment of acute vessel closure. During the subsequent 6 months, the emphasis should shift to the evaluation of recurrent symptoms and prevention of restenosis. We discuss the methods used to assess the results of coronary angioplasty and suggest guidelines for managing patients after the procedure.