IS THERE ANY ASSOCIATION BETWEEN DISSECTION AFTER SUCCESSFUL PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY AND LATE RESTENOSIS - AN ANGIOGRAPHIC STUDY

Restenosis continues to be the most important limitation of percutaneo us transluminal coronary angioplasty (PTCA). Many clinical, angiograph ic, and procedural variables are thought to be related to the developm ent of restenosis. This study was aimed at investigating the effects o f no dissection, minor dissections, and major dissections on the longt erm outcome of lesions after successful PTCA. The study group comprise d 91 patients with 100 lesions who underwent successful PTCA and in wh om follow-up coronary angiography was performed at 8.8 +/- 7.2 (two to twenty-three) months after dilation. Dissections were classified acco rding to the National Heart, Lung, and Blood Institute criteria. Reste nosis was defined as more than 50% stenosis at follow-up angiography. Restenosis rates were found to be 22% in the no-dissection group (10 r estenoses in 46 patients), 27% in the minor dissection group (11 reste noses in 40 patients), and 36% in the major dissection group (5 resten oses in 14 patients). The authors applied corrected Yates Chi-square t est and no difference was observed in the restenosis rate between the group without any dissections and that with minor dissections (P > 0.0 5). However, a statistically significant difference was observed in th e restenosis rate between the major dissection group and the other two groups (P < 0.05). The authors conclude that the occurrence of major dissections after successful PTCA may adversely affect the long-term o utcome and may increase the restenosis rate.