Cg. Suresh et al., LATE SYMPTOM RECURRENCE AFTER SUCCESSFUL CORONARY ANGIOPLASTY - ANGIOGRAPHIC OUTCOME, International journal of cardiology, 42(3), 1993, pp. 257-262
Objectives: To determine the angiographic appearance of the dilated co
ronary artery and the cause of symptoms in patients who presented with
a return of chest pain more than 1 year after successful percutaneous
transluminal coronary angioplasty (PTCA). Design: Retrospective analy
sis of coronary angiograms and review of case histories. Patients and
methods: 112 patients who underwent repeat coronary arteriography for
investigation of chest pain 13-105 (median, 30) months after successfu
l coronary angioplasty were studied. All patients were free of symptom
s for at least 12 months after the initial angioplasty. Results: A ret
urn of chest pain was attributed to restenosis in 12 patients (11%), t
o a new lesion or worsening of pre-existing coronary lesion in 56 pati
ents (50%), and to both restenosis and stenosis in non-dilated coronar
y segments in 10 patients (9%). There was no restenosis in 112 of the
134 dilated lesions (84%). In 34 patients (30%), there was no signific
ant stenosis in either dilated or non-dilated coronary segments. Concl
usions. In patients undergoing coronary angiography for the investigat
ion of recurrent chest pain more than 1 year after successful coronary
angioplasty, the majority of dilated coronary segments had a good ang
iographic appearance. Late onset angina following PTCA is usually due
to new coronary lesions or worsening of pre-existing mild stenosis.