Korean Circ J.  1986 Sep;16(3):317-329. 10.4070/kcj.1986.16.3.317.

Percutaneous Transluminal Coronary Angioplasty(PTCA) of Coronary Artery Stenosis

• Cho SY
• Lee WK
• Shim WH
• Chung NS
• Park KS
• Jang YS
• Bahk SJ

• KMID: 1668790
• DOI: http://doi.org/10.4070/kcj.1986.16.3.317

Abstract

Since the introduction of PTCA by Gruntzig in 1977, this is now widely used in some subsets of patients with coronary artery disease and is an effective alternative to surgery for many patients. In the 3 years from June 1983 to June 1985, PTCA was attempted in 33 patients with coronary artery disease at the Severance Hospital. There were 26 men and 7 women, whose mean age was 51 years(31-68year). Seven patients had a previous myocardial infarction. Thirty one of 33 patiens presented with chest pain. Twenty four patients had unstable angina and 7 stable angina. the median duration of angina was 5 months(1-120months). 29 had one vessel disease. One had left main disease, 1 two-and 2 three-vessel disease. PTCA was attempted on lesions located in the left anterior descending artery in 26 patients, right coronary artery in1. Successful dilation(stenosis opened by 20% or more of the normal luminal diameter)was achieved in 24 patients(73%). Seventy seven of the stenosis of the LAD and 75% of the RCA was succesfully dilated, whereas PTCA was failed in all 2 patients with a stenosis of the LCX. One patients with a stenosis of the left main artery was succesfully dilated. The mean degree of stenosis was reduced from 77+/-2% to 34+/-2%(P<0.001). The mean pressure gradient was diminished from 53+/-8mmHg to 18+/-6mmHg(P<0.001). Acute coronary occlusion occured in 4 patients(12%). Three of them developed acute myocardial infarction. Emergency coronary bypass operation was done in 2 patients, but one died on the day of operation. Follow-up clinical assessment in the hospital after successful angioplasty indicated freedom from angina in the most of successfully dilated patietns. Eleven patients who underwent successful dilation had basesline and follow-up(within 2 weeks after PTCA) transmill tests. Nine of 11 patients with a positive treadmill test before PTCA obtained negative results after successful angioplasty. Mean exercise duration increased from 316+/-46sec to 601+/-34sec(P<0.001). Eight patients have developed recurrence of angina(recurrence rate;33%) during follow-up period of 3 to 36 months(medial;10 months). In 6 of these cases, restenosis has been documented angiographically within 3 months of dilatation. Four asymptomatic patients have had follow-up angiography. In all patients, the dilated segments was unchanged or improved. Repeat PTCA was attempted in 5 patients with a success rate of 80% without any complications. This initial expierence with PTCA indicates that it is an effective method of relieving coronary stenosis and ischemic symptoms in selected patients. But it carries an inherent risk of serious complications. Also restenosis is a persistent problem with PTCA. Repeat PTCA can be done with a high success and a low complication rate.

MeSH Terms

Angina, Stable
Angina, Unstable
Angiography
Angioplasty
Arteries
Chest Pain
Constriction, Pathologic
Coronary Artery Disease
Coronary Occlusion
Coronary Stenosis*
Coronary Vessels*
Dilatation
Emergencies
Exercise Test
Female
Follow-Up Studies
Freedom
Humans
Male
Myocardial Infarction
Phenobarbital
Recurrence
Phenobarbital