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.
Original language | English |
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Pages (from-to) | 575-579 |
Number of pages | 5 |
Journal | American Heart Journal |
Volume | 133 |
Issue number | 5 |
DOIs | |
State | Published - May 1997 |
Externally published | Yes |
Bibliographical note
Funding Information:Supported by a grant from the National Council for Research and Development, Israel, and GSF Munchen, Germany, and by a grant from the United Israel Appeal of Canada Inc.
Funding
Supported by a grant from the National Council for Research and Development, Israel, and GSF Munchen, Germany, and by a grant from the United Israel Appeal of Canada Inc.
Funders | Funder number |
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United Israel Appeal of Canada Inc. | |
Growing Spine Foundation | |
National Council for Forest Research and Development |