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[Coronary angioplasty in 40 patients with 518 stenoses: complications and surgical support]
L A Mata1, J Frade García, R Mendoza Gómez
1Servicio de Hemodinamia, Hospital Español, México, D.F.
Insights
Coronary angioplasty successfully treated 518 stenoses in 400 patients, achieving a 92% success rate with minimal complications. A low-risk subset can undergo the procedure without surgical standby.
Area of Science:
- Cardiology
- Interventional Cardiology
Background:
- Coronary angioplasty is a key intervention for coronary artery disease.
- Assessing outcomes and safety is crucial for patient selection and procedural planning.
Purpose of the Study:
- To analyze the outcomes and complications of coronary angioplasty in a large patient cohort.
- To evaluate the safety of performing angioplasty without surgical standby in selected patients.
Main Methods:
- Retrospective analysis of 400 patients undergoing 518 coronary angioplasty procedures.
- Inclusion of patients with various clinical syndromes including unstable angina and myocardial infarction.
- Categorization of procedures based on the need for surgical standby (emergency vs. low-risk).
Main Results:
- High procedural success rate of 92% (478/518 segments), with mean stenosis reduction from 88% to 15%.
- Overall major complication rate of 6% (25/400 patients), including 3% myocardial infarction and 1% mortality.
- Procedures without surgical standby in 220 patients showed low complication rates, particularly in the low-risk group (2% MI, no deaths).
Conclusions:
- Coronary angioplasty demonstrates a high success rate and acceptable complication profile in well-selected patients.
- A subset of low-risk patients can safely undergo coronary angioplasty without surgical standby, optimizing resource allocation and patient experience.
Abstract:
We analyze the outcome of 400 patients (pts) with coronary angioplasty in 518 stenosis (314 men, age 29 to 80). The clinical syndromes were unstable angina in 252 pts, acute myocardial infarction (MI) in 26, angina or residual ischemia after thrombolysis for MI in 34 and 18 pts with post-MI angina. Success was achieved in 478 of 518 segments (92%). Mean stenosis was reduced from 88 to 15%. Revascularization was complete in 92% of pts. Primary success was 74% in total occlusions. We had 25 major complications (6%): 8 emergency bypass surgery (2%), MI in 12 pts (3%) and 5 deaths (1%). The procedures were performed without surgical standby in 220 pts: in 68 it was an emergency and in 152 it was considered a low risk procedure. Major complications in emergency cases were 3 MI (4%) and 2 deaths (3%). In the low risk procedures there were no deaths, 3 MI (2%) and 1 aortic dissection. We conclude that in well selected patients coronary angioplasty gives a high success rate with very few complications. Furthermore, it is possible to identify a very low risk subset of patients in whom the procedure can be performed without having a surgical standby.