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[Complex angioplasty. (I). Single dilatation versus multiple dilatation in patients with multi-vessel coronary
Insights
Coronary angioplasty effectively treats multivessel disease, even without dilating all affected vessels. Clinical improvement was sustained in 81% of patients, with survival unaffected by dilation numbers.
Area of Science:
- Cardiology
- Interventional Cardiology
Background:
- Multivessel coronary artery disease requires effective revascularization strategies.
- Coronary angioplasty is a primary treatment option for such conditions.
Purpose of the Study:
- To evaluate the efficacy and outcomes of coronary angioplasty in patients with multivessel disease.
- To determine if dilating all affected vessels is necessary for successful outcomes.
Main Methods:
- Retrospective analysis of 752 patients with multivessel disease undergoing coronary angioplasty.
- Data collection on procedural success, complications, recurrence rates, and long-term clinical improvement.
Main Results:
- Successful angioplasty was achieved in 658 patients (87.5%).
- Complications included transmural infarction (2.5%), urgent surgery (3.5%), and mortality (1.9%).
- Recurrence occurred in 35% of patients, with 94.7% success in repeat angioplasty. Clinical improvement was 81% at 31 months. Survival was not impacted by the number of dilations but was affected by prior surgery and ventricular dysfunction.
Conclusions:
- Coronary angioplasty is effective for multivessel disease, even when not all vessels are dilated.
- Long-term clinical improvement and survival are achievable, though influenced by patient comorbidities.
Abstract:
Coronary angioplasty was successfully performed in 658/752 multivessel disease patients. One lesion was attempted in 338 patients (45%); two or more in 414 patients (55%). Complications occurred in 39 patients (5.2%): 19 (2.5%) had a transmural infarction, 26 (3.5%) urgent surgery, and 14 (1.9%) died. Recurrence occurred in 233/658 (35%) patients with 162/171 (94.7%) having a successful second angioplasty. Clinical improvement (follow-up: 31 months) remained in 81% of successful patients. Survival was not affected by the number of dilations performed but was adversely affected by the presence of prior surgery and ventricular dysfunction. Angioplasty can be an effective treatment without the need to dilate all vessels.