INFLUENCE OF ANGIOGRAPHIC MORPHOLOGY ON THE ACUTE AND LONGER-TERM OUTCOME OF PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY IN PATIENTS WITH AORTIC-STENOSIS DUE TO NONSPECIFIC AORTITIS

Purpose: We studied the relationship of initial angiographic morpholog y in patients with aortic stenosis due to nonspecific aortitis and its relationship to immediate and later outcome following percutaneous tr ansluminal angioplasty (PTA). Methods: Correlation was performed in 10 successive patients by retrospective analysis. All had clinically ina ctive nonspecific aortitis and hemodynamically significant aortic sten osis resulting in hypertension or lower limb claudication. Five patien ts had discrete concentric stenosis; the other five had eccentric sten osis with diseased aortic segments adjacent to the stenosis. Results: The five patients with concentric stenosis (Group I) had primarily suc cessful and uncomplicated PTA with sustained improvement. The five pat ients (Group II) with eccentric stenosis had initial success in three patients and two initial treatment failures with one patient showing l ate improvement. Four of these patients developed large intimal flaps. One of these had an aneurysm during follow-up. Follow-up angiograms i n five patients showed remodelling with further angiographic and clini cal improvement. Conclusion: Eccentricity of the stenosis and diffuse aortic disease correlate unfavorably with immediate outcome of PTA but late improvement may still be seen.