RECURRENCE AFTER PERCUTANEOUS CORONARY AN GIOPLASTY IN CHRONIC CORONARY ANGIOPLASTY IN CHRONIC CORONARY-OCCLUSION - IS RE-PTCA WORTHWHILE

In chronic coronary artery occlusion, the success rate of coronary ang ioplasty (PTCA) is relatively low and the rate of recurrence is high. Significant predictors of restenosis and the therapeutic value of redi latation in recurrence was checked from January 1986 till June 1990 in 284 successfully dilated patients with chronic coronary artery occlus ion. Out of 101 patients with recurrence detected by angiography (rate 60%), 58 showed a stenosis of more than 50% and 43 showed a re-occlus ion. The recurrence rate was 74% when the length of the occluded segme nt was >10 mm and 54% when it was <10 mm (p < 0.05). Furthermore, when the residualstenosis after primary PTCA was >30%, recurrence occured in more than 75%, compared with 45% when a residualstenosis was <30% ( p < 0.001). In 80 patients with recurrence, a re-PTCA was attempted. T he successrate of the second operation was 78.7% (63/80 patients) as c ompared to 55.8% in primary PTCA (p < 0.001). A second recurrence was diagnosed in 17 patients (27%), and an attempt at dilation was carried out in all. This was successful in 4/4 patients with a third recurren ce. There were no complications.