[Emergency and elective percutaneous recanalization in ischemic heart disease]

The success and complication rates of programmed angioplasty performed after diagnostic coronarography and of ad hoc angioplasty performed at the time of the diagnostic catheterization are analysed in the study. We have attempted percutaneous recanalisation of 1071 lesions on 440 patients and dilated an average 2.4 stenoses or occlusions by patient. Immediate intervention was performed on 59.5% of patients with overall 91.7% success rate. The need for emergency surgery was 0.7%, periprocedural myocardial infarction was observed in 1.5%, and the mortality rate was 1.5%. The success and complication rates were similar for both studied groups. In the ad hoc angioplasty group there were relatively more easily solvable cases concerning the techniques, however the incidence of unstable angina and acute, emergency settings were more frequent. Ad hoc angioplasty does not diminish the success rate and resulted a faster, and more spectacular recovery in the above severe cases. Extensive experience with ad hoc angioplasty has proven it to be reasonable approach, efficient and safe variation not only in rescue, but also in complex angiological settings, if the considerable logistics are possible in an individual cardiovascular center. The provision of ischaemic heart disease patients is subject to the planning and creating such anti-ischaemic interventional cardiological centers in Hungary.