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Angiographic deterioration of target coronary artery narrowing as a result of percutaneous balloon angioplasty.

Abstract：

:We evaluated the long-term angiographic outcome of balloon angioplasty by comparing original and follow-up target coronary narrowing. Rather than using restenosis to determine outcome, as in most angioplasty studies, we took an unusual approach and analyzed outcome in terms that are commonly used in progression and regression studies after medical interventions. Quantitative angiographic measurements were undertaken in 315 narrowings with an initial diameter stenosis <90% before and after angioplasty and at follow-up. Angiographic deterioration (>10% increase in follow-up diameter stenosis) was identified in 44 (14%) narrowings. Angiographic deterioration was not influenced by age, sex, risk factors, lipid profile, or the indication for angioplasty. Deterioration was also not predicted by the severity, length, or the location of the narrowing. The deteriorating narrowings had a higher recoil after dilatation compared with narrowings with angiographic improvement (21% +/- 31% vs 12% +/- 17%, p = 0.006); the residual stenosis after angioplasty was therefore higher. The late loss was also significantly increased compared with narrowings with angiographic improvement (65% +/- 26% vs 8% +/- 24%, p < 0.001). We conclude that the incidence of angiographic deterioration of coronary disease as a result of restenosis is uncommon but not negligible. Interventional cardiologists should resist the temptation to dilate mild, silent coronary narrowings because the procedure might have an unfavorable angiographic (and probably clinical) effect.

journal_name

Am Heart J

journal_title

American heart journal

authors

Rozenman Y,Gilon D,Sapoznikov D,Lotan C,Mosseri M,Hasin Y,Gotsman MS

doi

10.1016/s0002-8703(97)70153-4

subject

Has Abstract

pub_date

1997-05-01 00:00:00

pages

575-9

issue

5

eissn

0002-8703

issn

1097-6744

pii

S0002870397001117

journal_volume

133

pub_type

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