Author + information
- Received May 7, 1985
- Revision received July 17, 1985
- Accepted August 12, 1985
- Published online December 1, 1985.
- Luis Adolfo Mata, MD,
- Xavier Bosch, MD,
- Paul R. David, MD, FACC,
- Hans J. Rapold, MD,
- Thierry Corcos, MD and
- Martial G. Bourassa, MD, FACCa
- ↵aAddress for reprints: Martial G. Bourassa, MD, Montreal Heart Institute, 5000 East, Belanger Street, Montreal, Quebec, HIT I C8, Canada.
Percutaneous transluminal coronary angioplasty is an accepted treatment for selected patients with single vessel disease but has not been rigorously evaluated in patients with double vessel disease. Among 769 patients undergoing transluminal coronary angioplasty between 1980 and 1984, 74 with double vessel stenosis of 50% or more underwent double vessel coronary angioplasty. Primary success was obtained for both lesions in 63 patients (85%), for one lesion in 11 patients (15%) and for 137 (93%) of 148 segments overall. Except for myocardial infarction in one patient, no serious complication occurred. Before coronary angioplasty, 15 patients had unstable angina, 14 had Canadian Cardiovascular Society class III and 32 class I to II effort angina and only 2 were asymptomatic. Six months after coronary angioplasty, 27 were asymptomatic, 27 had class I to II and 5 had class III effort angina and 2 had sustained an episode of unstable angina. During the follow-up study, two patients had an infarction and one had coronary artery bypass surgery.
Coronary arteriography was performed at a mean of 5.5 ± 2.1 months after coronary angioplasty in all but three patients. Restenosis was found in 30 (23%) of 132 segments with angiographic control. Restenosis was present in one vessel in 17 patients and in both vessels in 4; 40 patients (66%) had no restenosis. Of the 34 patients with definite or probable angina, 50% had restenosis and 19% of patients with restenosis were symptom free. By stepwise logistic regression analysis, angioplasty site (p = 0.0003), degree of residual stenosis (p = 0.001), calcified stenosis (p = 0.01) and balloon/artery diameter ratio (p = 0.02) were retained as predictors of restenosis.
Thus, double transluminal coronary angioplasty can be performed in selected patients with double vessel disease with a high primary success rate and very low incidence of complications although, as expected, the restenosis rate per patient is higher than in single vessel coronary angioplasty.
Supported in part by the Jean-Louis Lévesque Foundation, Montreal and the Montreal Heart Institute Research Fund, Montreal, Quebec, Canada.
- Received May 7, 1985.
- Revision received July 17, 1985.
- Accepted August 12, 1985.
- American College of Cardiology Foundation