ONE-STAGE CORONARY ANGIOGRAPHY AND ANGIOPLASTY

The combination of diagnostic angiography and angioplasty as a single procedure is becoming common practice in many institutions, but the fe asibility and safety of this strategy have not been reported. This rep ort describes 2,069 patients who underwent coronary angioplasty over a 3-year period at an institution where combined angiography and angiop lasty is the norm. All patients were prepared before angiography for p otential immediate angioplasty. In 1,719 patients, angioplasty was per formed immediately after the diagnostic angiogram, while separate proc edures were performed in 350 patients. Of those 350 patients, 254 were referred for angioplasty after diagnostic angiography at other hospit als. One thousand one hundred ninety-seven patients were admitted elec tively for treatment of stable angina pectoris, and 872 underwent proc edures during hospitalization for unstable angina or acute myocardial infarction. One thousand nine hundred seven patients (99.2%) had succe ssful angioplasties; in 130 patients (6.3%) the lesion could not be di lated, but no complication occurred, and in 32 patients (1.5%) angiopl asty ended with a major complication (0.8% death, 1.0% Q-wave myocardi al infarction, 0.5% emergency coronary artery bypass surgery). There w as no difference between the combined and staged groups with regard to success, major and minor complication rates or in length of hospitali zation after angioplasty. We conclude that routine combined strategy f ar angiography and angioplasty is feasible, safe, easier for the patie nt, and more cost-effective than 2 separate procedures.