[Transluminal angioplasty--unstable angina, fresh infarct]

Transluminal coronary angioplasty is successfully used in stable and unstable angina. Out of 107 patients admitted with unstable angina 28% were treated medically, 24% operatively and 48% by angioplasty. In a total of 116 patients the stenosis diameter was enlarged from 75.0 +/- 11.0% obstruction to 25.1 +/- 16.4% (improvement 49.9 +/- 16.5%) without differences between concentric and eccentric or right and left coronary stenosis. In 11 out of 22 patients with total coronary occlusion of recent origin the vessel was reopened by the balloon and enlarged to a resting stenosis of 22.3 +/- 16.4%. There were no differences in the success- and the complication rate between stable and unstable angina. After successful thrombolysis residual stenoses greater than 50% are dilated during the same session. In a randomized prospective study 51 patients were dilated immediately (group I) and 48 patients (group II) treated conservatively. In group I the reinfarction- and the cardiac death-rate was two patients compared to seven patients in group II. After four weeks there was one reocclusion (3%) compared to five (17%) and a residual stenosis of 31.9 +/- 24.4% versus 78.0 +/- 15.2%. Angioplasty can be used with good results and a low complication rate in unstable angina and following successful thrombolysis.