Incidence and consequences of periprocedural occlusion. The 1985-1986 National Heart, Lung, and Blood Institute Percutaneous Transluminal Coronary Angioplasty Registry.

Abstract

Registry, 122 (6.8%) had periprocedural occlusion (4.9%o in the catheterization laboratory, 1.9%o outside the laboratory). Baseline patient factors independently associated with increased occlusion rates included triple-vessel disease, high risk status for surgery, and acute coronary insufficiency. Lesion characteristics showing significant positive association included severe stenosis before PTCA, diffuse or multiple discrete morphology, thrombus, and collateral flow from the lesion.Intimal tear and dissection were also very strongly associated with occlusion. Sixty patients (49%) had a transient occlusion that was reopened with PTCA, 43 (35%) were not redilated and managed with bypass surgery, and 19 (16%) were not redilated and managed medically. In-hospital mortality was 5% in each of these treatment groups, compared with 1% in occlusion-free patients. In-hospital infarction rates ranged from 27% in patients with transient occlusion to 56% in the patients managed with surgery, compared with 2% in patients without occlusion. During 2 years of follow-up, somewhat increased mortality continued in patients with occlusion, whereas follow-up infarction rates were comparable for all patients regardless of occlusion. Patients with an occlusion that was reopened or managed medically had increased rates of surgery during follow-up. Rates of repeat PITCA were comparable (about 23% by 2 years) in patients with transient occlusion and those without occlusion. Occlusion remains a serious complication of angioplasty and is associated most strongly with major events and surgical procedures that occur during the in-hospital period. (Circulaon 1990;82:739-750) T he occurrence of periprocedural occlusion either in or out of the catheterization laboratory has remained a serious complication of percutaneous transluminal coronary angioplasty

Incidence, Morphology, Angiographic Findings, and Outcomes of Intramural Hematomas After Percutaneous Coronary Interventions

“…[1][2][3] Stents have dramatically reduced this ischemic complication; however, several case reports have shown a different type of dissection morphology suggestive of an intramural hematoma. 4 -7 Recently, the American College of Cardiology Task Force on Clinical Expert Consensus Documents reported the standards for the acquisition, measurement, and reporting of intravascular ultrasound (IVUS) studies.…”

ABC Stenosis Morphology Classification and Outcome of Coronary Angioplasty

“…The outcome of coronary angioplasty has been documented in large-scale registries, [17][18][19] which in part served as the basis for establishing the ACC/AHA criteria. An earlier retrospective study failed to predict the individual risk of abrupt vessel closure.…”

The relation between preprocedural C‐reactive protein levels and early and late complications in patients with acute myocardial infarction undergoing interventional coronary angioplasty

“…[3][4][5] Normal CRP levels had a 100% negative predictive value for early adverse events in patients post AMI and identified a subset of patients (43% of the whole population) who did not require additional treatment until hospital discharge. [6][7][8] Percutaneous transluminal coronary angioplasty (PTCA) with or without stent implantation is an established revascularization procedure; however, restenosis rates still range between 30-60% 6 and 15-30%, 7 respectively Preprocedural identification of low-and high-risk patients who might benefit from additional procedures 6,8 would be desirable. However, the predictors of early [7][8][9][10] and late complications [11][12][13][14][15] have a low predictive value, [15][16][17][18] are available only after procedures, 9,14 or are not easily applicable in clinical practice.…”

“…10,12,13 Inconsistent and weak correlation with early complications following PTCA was reported for female gender, extreme age, diabetes, multivessel disease, lesion characteristics, and hemostatic variables. [6][7][8][9][10][11][12][13][14][15][16][17][18] This study was therefore undertaken to investigate the short-and long-term prognostic value of preprocedural serum levels of CRP in patients with AMI receiving PTCA/stenting.…”