RESULTS OF CONVENTIONAL PTCA IN OSTIAL LE SIONS

Stenoses in the ostium of the right and left coronary artery or venous bypass grafts as well as lesions in the origin of LAD and LCX from le ft main are in disrepute to be associated with low acute success rates and high rates of complication and restenosis. Several new techniques therefore claim indication in these cases. Among 5990 patients treate d in Frankfurt between 1977 and 1992, 60 showed ostial lesions, the pu rpose of the study was to compare acute and long term results with a c ontrol group. 60 patients with ostial stenoses (group A) were compared with 60 patients with non-ostial lesions in selecting the chronologic ally following intervention (group B). The groups were comparable rega rding age, sex and vessel distribution. In group A, 20 stenoses were l ocated in the ostium of RCA or LCA, 6 in the ostium of venous bypass g rafts and 34 at the origin of LAD and LCX. Acute success rate was 83.3 % in group A vs. 81.6% in group B (n.s.). The need for emergency bypas s surgery was 1.7% in group A and 5% in group B (n.s.). Follow-up angi ography 4 months after the procedure performed in 39/50 patients in gr oup A and 34/49 patients in group B showed restenosis in 33.3% in grou p A and 26.6% in group B (n.s.). It is concluded that PTCA in ostial l esions is better than its reputation. Acute and long-term results were comparable to non-ostial lesions treated in the same period of time.