Long-Term Results of Coronary Balloon Angioplasty

Abstract

Long-term results after coronary balloon angioplasty are characterized by an eventful early period up to six months, with about a 30% recurrence rate per lesion, and by a stable situation thereafter. Myocardial infarction due to the dilated site is extremely rare during follow-up because the smooth, elastic, inner lining of a restenosis is much less prone to thrombosis than the initial plaque. A positive effect of coronary angioplasty on survival has not been documented, but there is clear functional improvement over the natural course of the untreated disorder. The improvement is comparable to that attained by bypass surgery if repeat angioplasty during the first months is considered as part of the procedure rather than as proof of failure.

Probucol inhibits neointimal thickening and macrophage accumulation after balloon injury in the cholesterol-fed rabbit.

“…Percutaneous transluminal angioplasty is a common form of therapeutic intervention for symptomatic coronary artery disease (1). It involves the mechanical dilatation of the stenosed coronary artery by using an inflatable balloon catheter (2).…”

“…It involves the mechanical dilatation of the stenosed coronary artery by using an inflatable balloon catheter (2). Although it is a safer and less invasive procedure than coronary artery bypass surgery, percutaneous transluminal angioplasty is associated with a high long-term failure rate; 30-406% of coronary vessels reocclude within the first year of treatment (1,3,4). The accumulation of vascular smooth muscle cells within the intima is the major contributor to the formation of the restenotic lesion.…”

Balloon Angioplasty – The Legacy of Andreas Grüntzig, M.D. (1939–1985)

“…Four months after the first intra-operative coronary angioplasties in San Francisco, and only because Grüntzig had Senning’s unreserved support ( 36 , 38 , 39 ), Grüntzig successfully performed the first PTCA in Zürich in a conscious patient – 38-year old Adolf Bachmann – who had been originally scheduled for bypass surgery because of an isolated LAD stenosis [reviewed in Ref. ( 28 , 131 , 133 , 135 , 139 – 142 )]. The nurse assisting Grüntzig took his notes during the procedure.…”

“…Forty years after its introduction, balloon angioplasty continues to save lives of patients with acute myocardial infarction ( 131 , 135 , 140 , 142 ). Balloon angioplasty saved patients from disability by preventing leg amputations, as demonstrated by both Dotter and Grüntzig with their very first patients ( 22 , 60 ).…”