IMMEDIATE AND FOLLOW-UP RESULTS OF CORONARY ANGIOPLASTY - LESSONS FORTHE FUTURE

In a series of 129 patients having coronary angioplasties in St, James 's Hospital in 1989, the average age was 54.8 (30-77 years), There wer e 102 (79%) men and 27 (21%) females, Clinical indications were unstab le angina 62, stable angina 26, post myocardial infarction 39 and asym ptomatic ischaemia 2, The distribution of coronary disease was single vessel 62%, double vessel 28%, triple vessel 7% and previous coronary bypass surgery 3%, Only 10 patients had more than one vessel dilated, Primary success was achieved in 119 (92%), there were no deaths, 3 pat ients had abrupt closure of the vessel during angioplasty and sustaine d a nonfatal myocardial infarction, 1 patient required urgent bypass s urgery and 2 patients had peripheral vascular complications requiring surgery, There were 6 failed angioplasties, 4 of which had chronic tot al occlusion. At a mean follow-up of 5.3 months, 85 patients had no sy mptoms, 33 had angina, 2 developed myocardial infarction and 1 died su ddenly at 5 months, Repeat angiography was performed in 96 (79%) patie nts, At follow-up, no symptoms were present in 69% of those with singl e vessel disease and 70% of multivessel disease, Of those who had more than one vessel dilated in multivessel disease, 80% were asymptomatic (P=NS), There were 11 patients with initial total occlusion at presen tation, 4 had failed angioplasties, 5 recurrent angina of which 4 reoc cluded and 1 restenosed and only 2 were asymptomatic and without reste nosis. Angioplasty was performed with primary success (92%) and follow up results (70% asymptomatic). Those with single or multivessel disea se had similar clinical outcome, favouring the use of target vessel an gioplasty. Long term results following angioplasty of chronic total oc clusions were poor and suggests the need for additional treatment.