ANGIOPLASTY OF THE PROXIMAL LEFT ANTERIOR DESCENDING ARTERY OUTSIDE THE ACUTE-PHASE OF MYOCARDIAL-INFARCTION - RESULTS IN A SERIES OF 100 CONSECUTIVE CASES

The indications of percutaneous transluminal coronary angioplasty (PTC A) of the proximal left anterior descending artery (LAD 1) must take i nto consideration the importance of the threatened myocardial territor y in case of complications and the supposedly increased risk of resten osis of this arterial segment, One hundred consecutive patients (avera ge age 59.9 +/- 11.4 years with 77% of men) outside the acute phase of myocardial infarction were included in this retrospective open study from January ist 1988 to March Ist 1992. There were 76 cases of single vessel. The average left ventricular ejection fraction was 64.8 +/- 1 2%. During the hospital period, there were no deaths, 1 myocardial inf arction despite emergency coronary bypass surgery, and 2 programmed co ronary bypass procedures. During follow-up, ''clinical restenosis'' as defined by the authors was observed in 29.7% of cases; 1 patient died of cardiovascular causes, 18 had a repeat PTCA with a success rate of 100%. The clinical restenosis rate of repeat PTCA was 33%. One patien t underwent a third PTCA with a successful outcome. Ten coronary bypas s procedures were necessary. Restenosis was more common after PTCA of lesions situated on a bifurcation and when high inflation pressures ha d to be used. Restenosis was constant after repeat PTCA when the initi al restenosis occurred before the 60th day.