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Balloon angioplasty in multivessel coronary artery disease
Insights
Percutaneous transluminal coronary angioplasty is effective for multivessel coronary artery disease. This procedure offers a low-risk alternative to bypass surgery for selected patients when medical therapy fails.
Area of Science:
- Cardiology
- Interventional Cardiology
Background:
- Coronary angioplasty was initially limited to single-vessel disease.
- Multivessel coronary artery disease is common in symptomatic patients requiring revascularization.
Purpose of the Study:
- To evaluate the outcomes of balloon angioplasty in patients with multivessel coronary artery disease.
Main Methods:
- Retrospective analysis of 100 patients with multivessel disease who underwent percutaneous transluminal coronary angioplasty.
- Success defined as successful dilation without significant complication.
Main Results:
- 72% of patients had initially successful angioplasty.
- No deaths were reported.
- 25 patients required coronary artery bypass grafting, 6 urgently.
Conclusions:
- Coronary angioplasty is a safe and effective option for selected multivessel disease patients.
- It may serve as an alternative to coronary artery bypass grafting when medical treatment fails.
- Further clinical trials are needed for direct comparison with standard therapy.
Abstract:
Coronary angioplasty with use of the balloon catheter was initially performed only in patients with single-vessel coronary artery disease. Most symptomatic patients with coronary artery disease who require revascularization for control of their symptoms, however, have stenoses in more than one major coronary artery. Therefore, we have evaluated the results of balloon angioplasty in patients with multivessel disease. Of 261 patients who underwent percutaneous transluminal coronary angioplasty at our institution up to February 1983, 100 had multivessel disease. Of these 100 patients, 72 had an initially successful procedure, defined as successful dilation of one or more major coronary arteries without significant complication. Of the remaining 28 patients, 25 underwent coronary artery bypass grafting (6 on an urgent basis for coronary occlusion). No deaths occurred. In selected patients with multivessel disease, coronary angioplasty is associated with low morbidity and mortality and might be an excellent alternative to coronary artery bypass grafting when medical treatment fails. Percutaneous transluminal coronary angioplasty merits the critical comparison with standard therapy that can be achieved only in a properly designed clinical trial.