TREATMENT OF LONG CORONARY-ARTERY NARROWINGS WITH LONG ANGIOPLASTY BALLOON CATHETERS

Balloon angioplasty of long coronary artery narrowing has been associa ted with a lower rate of acute success, and a higher rate of acute com plications and restenosis than that observed for short narrowing. Angi oplasty catheters with longer length balloons (30 and 40 mm) are now a vailable, and the objective of this study was to determine the acute a nd long-term success for patients with long coronary artery narrowing treated with these longer balloons. All patients with long narrowing ( greater-than-or-equal-to 10 mm) treater with long balloons at 1 instit ution over a 1-year period were identified (93 narrowing in 89 patient s), and acute and long-term outcomes were carefully documented. Proced ural success (residual stenosis less-than-or-equal-to 50%) was 97%. Ab rupt closure occurred in 6% and major dissection in 11% of narrowing. Clinical success (procedural success without in-hospital death, bypass surgery or myocardial infarction) was achieved in 90% of patients. Re peat catheterization was performed in 61 patients (76% of those eligib le), and restenosis was found in 50 to 55%, depending on the definitio n used. The treatment of long coronary artery narrowing using angiopla sty catheters with longer balloons leads to high rates of acute succes s. However, there is a high rate of restenosis. New interventional dev ices for long sessions should be compared with long balloons in a rand omized controlled trial.