Percutaneous transluminal coronary angioplasty: Report from the registry of the National Heart, Lung, and Blood Institute

Kent, Kenneth M.; Bentivoglio, Lamberto G.; Block, Peter C.; Cowley, Michael J.; Dorros, Gerald; Gosselin, Arthur J.; Grüntzig, A; Myler, Richard K.; Simpson, John B.; Stertzer, Simon H.; Williams, David O.; Fisher, Lloyd D.; Gillespie, Mary Jo; Detre, Katherine M.; Kelsey, Sheryl F.; Mullin, Suzanne M.; Mock, Michael B.

doi:10.1016/0002-9149(82)90223-5

Cited by 379 publications

(57 citation statements)

References 6 publications

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“…Except for the severity of the coronary lesion, patient characteristics and the distribution of involved vessels of all patients were similar and were comparable to cases reported in the NHLBI registry. 3 Five of the 13 patients in group A had progressed from severe stenosis (90% to 99%, mean 93%) to coronary occlusion over the brief interval (1.5 to 13 weeks, mean 4.8) after diagnostic arteriography (figure 4). Eight other patients had total occlusion at the time of the initial diagnostic studies, which were performed a mean of 3.3 weeks before attempted angioplasty.…”

Section: Resultsmentioning

confidence: 98%

Transluminal angioplasty of occluded coronary arteries: use of a movable guide wire system.

Dervan¹,

Baim²,

Cherniles³

et al. 1983

Circulation

101

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Of 47 consecutive patients referred for coronary angioplasty, the procedure was attempted in 13 patients despite occlusion of the involved vessel. This included four patients with total coronary occlusion and nine with functional coronary occlusion (faint, late antegrade opacification in the absence of a discernible luminal continuity). All procedures were performed with an angioplasty system in which the leading guide wire could be moved independently of the dilatation catheter. Primary success was obtained in 54% (7/13) of patients with coronary occlusion compared with 85% (29/34) in the remaining patients with conventional stenoses between 75% and 95% (91 + 5%, mean + SD; p < .02). In patients with coronary occlusion, the mean residual stenosis after angioplasty (41%), the abrupt reclosure rate (8%), and the incidence of angiographically evident dissection (29%) were similar to those seen in the 34 patients who underwent angioplasty of conventional stenoses, although restenosis tended to be more common (43% vs Received April 11, 1983; accepted June 2, 1983. This work was done during the tenure of a research fellowship from the American Heart Association, Greater Boston Massachusetts Division, No. 13-435-812 (J. P. D.). 776in totally occluded vessels.' Angioplasty systems in which the leading guide wire can be moved independently of the balloon catheter have recently been developed and offer advantages over fixed wire systems in the performance of coronary angioplasty.4 I These advantages now appear to extend to coronary angioplasty of functionally occluded vessels, and this report describes our experience in 13 such patients, with attention to the unique technical and coronary hemodynamic considerations present in this patient population. MethodsOf 47 consecutive patients (ages 35 to 81 years) who underwent coronary angioplasty at the Beth Israel Hospital between December 1981 and February 1983, 13 patients (group A) did so despite total occlusion (100%) or functional total occlusion (99%) of the involved vessel. Total vessel occlusion (figure 1) was defined as absent antegrade filling beyond the lesion. Functional total occlusion (figure 2) was defined as faint, late antegrade opacification of the distal segment in the absence of a discernible luminal continuity on detailed review of the cineangiogram. The remaining 34 patients (group B) had conventional stenoses between 75% and 95% (mean 91 + 5%) with evident luminal continuity. CIRCULATION

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Section: Resultsmentioning

confidence: 98%

Transluminal angioplasty of occluded coronary arteries: use of a movable guide wire system.

Dervan¹,

Baim²,

Cherniles³

et al. 1983

Circulation

101

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“…Baseline characteristics of the patients undergoing emergency coronary surgery (group I) and of the control patients (group II) are compared in table 2 assessed on the diagnostic pre-PTCA angiogram (degree, length, calcification), and the procedural characteristics such as types of balloon catheters used and maximum inflation pressures are also similar (tables 3A and 3B). The detailed evaluation of angiographic stenosis morphology on the pre-PTCA angiograms available for review, however, yielded significant differences between the two groups.…”

Section: Methodsmentioning

confidence: 99%

Coronary dissection and total coronary occlusion associated with percutaneous transluminal coronary angioplasty: significance of initial angiographic morphology of coronary stenoses.

Ischinger¹,

Gruentzig²,

Meier³

et al. 1986

Circulation

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Coronary dissection and total coronary occlusion leading to emergency coronary surgery are the most frequent complications of percutaneous transluminal coronary angioplasty (PTCA) and their occurrence usually is unpredictable. To identify angiographic characteristics of coronary stenoses that may affect the incidence of these complications, the diagnostic pre-PTCA coronary angiograms of 38 consecutive patients (group I) undergoing emergency coronary surgery for dissection or occlusion were reviewed and compared with the angiograms of a random sample of 38 patients (stratified for left anterior descending and right coronary arteries) from a group of 1151 who did not need emergency coronary surgery (group II). Stenosis morphology before angioplasty was considered "complicated" if at least one of the following criteria was present: irregular borders, intraluminal lucency, and localization of stenosis in curve or at bifurcation. Baseline characteristics, maximum inflation pressures, types of balloon catheters used, and routinely registered angiographic stenosis properties (severity, length, eccentricity, and calcification) were similar in both groups. Irregular borders before PTCA were present in 22 of 38 patients in group I

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“…Histologic Changes Early After Angioplasty (Table 2 and Figure 4) The acute histologic consequences following angioplasty in the four groups are summarized in Table 2 ination, p<0.01. Thrombus occurred exclusively in the setting of vessel-wall dissection, which was more common in the high pressure groups, p<0.01.…”

Section: Angiography-acutementioning

confidence: 99%

Influence of inflation pressure and balloon size on the development of intimal hyperplasia after balloon angioplasty. A study in the atherosclerotic rabbit.

et al. 1989

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With the technical assistance of Sue Marie Sanabria and Francesca MigliaccioTo evaluate the effect of balloon size and inflation pressure on acute and subsequent outcome following balloon angioplasty (BA), 70 New Zealand White rabbits with bilateral femoral atherosclerosis were assigned to four groups: group 1, oversized balloon, low inflation pressure (n=35 vessels; balloon size, 3.0 mm/inflation pressure, 5 atm); group 2, oversized balloon, high inflation pressure (n=36; 3.0 mm/10 atm); group 3, appropriate size, low inflation pressure (n = 17; 2.5 mm/5 atm); and group 4, appropriate size balloon, high inflation pressure (n = 19; 2.5 mm/10 atm). Angiograms were obtained before, 10 minutes after, and 28 days after BA and read by two blinded observers using electronic calipers. The in vivo ballon-to-vessel ratio was measured for each group. There were eight non-BA controls. Rabbits were sacrificed either immediately (n=34) or at 28 days after BA (n=36), with the femoral vessels pressure perfused for histologic and morphometric analysis. The 3, 9/17 [53%]; p

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Percutaneous transluminal coronary angioplasty: Report from the registry of the National Heart, Lung, and Blood Institute

Cited by 379 publications

References 6 publications

Transluminal angioplasty of occluded coronary arteries: use of a movable guide wire system.

Transluminal angioplasty of occluded coronary arteries: use of a movable guide wire system.

Coronary dissection and total coronary occlusion associated with percutaneous transluminal coronary angioplasty: significance of initial angiographic morphology of coronary stenoses.

Influence of inflation pressure and balloon size on the development of intimal hyperplasia after balloon angioplasty. A study in the atherosclerotic rabbit.

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