HIGH BALLOON DILATATION PRESSURES IN PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY ARE NOT ASSOCIATED WITH HIGHER RATE OF SIGNIFICANT COMPLICATIONS

To examine the results of high balloon dilatation pressures during per cutaneous transluminal coronary angioplasty (PTCA), we retrospectively reviewed 482 angioplasty cases from our institution and divided them into three groups by the peak inflation pressure used during the proce dure. Group one was defined by inflation pressures of 1-6 atmospheres (atm), group two by 7-12 atm, and group three by 13-20 atm. There were 166 patients in group 1 (34.4%), 235 in group 2 (48.8%), and 81 (16.8 %) in group 3. The success rates were not statistically different; 90% in group 1, 96% in group 2, and 95% in group 3. Large dissections occ urred in 27 patients in group 1 (16.3%), 19 in group 2 (8.1%), and 4 ( 4.9%) in group 3 (P > 0.006). There were no differences in the rates o f death (1.2% vs. 0.9% vs. 1.2%), myocardial infarction (3.0% vs. 1.3% vs. 3.7%), or in-hospital CABG (3.0% vs. 1.7% vs. 1.2%) in groups 1, 2, and 3, respectively. Six-mo target vessel revascularization rates a lso were not different: 19% vs. 13% vs. 18%. In summary, selectively u sing high balloon pressures during PICA does not result in increased c omplications. (C) 1995 Wiley-Liss, Inc.