LASTING DILATATION AFTER UNSUCCESSFUL PER CUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY

Between August 1991 and December 1993, a total of 7011 percutaneous tr ansluminal coronary angioplasties (PTCA) were performed. In 24 of them , the acute results were unsatisfactory, an autoperfusion balloon cath eter was tolerated without com- plications and prolonged inflation (30 min to one hour) brought no improvement. In these 24 patients (22 men , two women; mean age 60 [33-81] years) the duration of inflation was, if possible, increased to at least 6 hours. In three patients the inf lation had to be terminated after 2 or 4 hours, respectively, because of angina or for technical reasons. In 18 of the 24 patients subsequen t angiography demonstrated residual restenosis of less than 50%, with a mean degree of stenosis of 18 +/- 14%. But lasting dilatation was no t achieved in 6 patients: occlusion persisted in one and marked residu al stenosis in two patients, while stent implantation was required in three. These results indicate that, in case of dissection or acute occ lusion with failure after prolonged balloon inflation of 30 to 60 min, extending the duration of inflation to many hours can often produce g ood results so that stent implantation can be avoided.