[Long-term clinical angiographic follow-up undergoing PTCA more than 10 years]

To evaluate longer-term outcome of the balloon angioplasty, a serial follow-up angiographic study at Early (< or = 1 year) and 10 year (yr)s was designed. Between April 1982 to December 1984, balloon angioplasty for native coronary arteries was successful in 320 patients (pts) (age: 60 +/- 9, male 81%, multi vessel disease 45%) or 436 de novo lesions (les) (LAD: 56%, RCA 20%, LCX 24%). At 10 yrs, 78% of pts were free from death, 66% free from death/MI/CABG, 48% free from death/MI/CABG/target lesion revascularization. 41% free from death/MI/CABG/target lesion revascularization/PTCA for new les (NL). Early follow-up angiography (FUA) was performed and cine films were available in 176 pts (55%). Seventy-three pts (23%) underwent target lesion revascularization and 11 pts died (cardiac: 3, non-cardiac: 8) within 1 yr. Excluding these 84 pts, 236 pts were eligible for longer term FU. FUA at 10 yrs was performed and cine films were available in 95 pts (40%). CAAS II was used for quantitative analysis. [table: see text] MLD did not change between Early and 10 yrs. Angiographic restenosis (defined as > 50% DS at FU) was occurred in 75/176 pts (43%) within 1 year and 15/95 pts (16 %) between 1 and 10 yrs (P < 0.0001). In contrast, NL was occurred in 26/176 pts (15%) within 1 year and 45/95 pts (47%) between 1 and 10 yrs (P < 0.0001).

1) Restenosis rarely occurred beyond 1 yr after balloon angioplasty. 2) Ischemic events beyond 1 yr were often related to development of NL rather than restenosis. 3) Safety and efficacy of balloon angioplasty appeared to be sustained at 10 yrs.