To assess the likelihood of procedural success in patients with multivessel coronary disease undergoing percutaneous coronary angioplasty, 350 for type C stenoses, a 61% success and a 21% complication rate. The subdivision into types Bi and B2 provided significantly more information in this clinically importantintermediate risk group than did the standard ACC/AHA scheme. The stenosis characteristics of chronic total occlusion, highgrade (80-99% diameter) stenosis, stenosis bend of more than 60°, and excessive tortuosity were particularly predictive of adverse procedural outcome. This improved scheme may improve clinical decision making and provide a framework on which to base meaningful subgroup analysis in randomized trials assessing the efficacy of percutaneous coronary angioplasty. (Circulation 1990;82:1193-1202 T he clinical and anatomic heterogeneity of short-and long-term outcomes with percutaneous patients with multivessel coronary artery discoronary angioplasty (PTCA). Previous short-term ease might expectedly lead to differences in follow-up studies have focused on the feasibility andFrom the Divisions

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Acute myocardial ischemia is known to cause impairment of both left ventricular systolic and diastolic function. To further investigate these changes as well as their relation to common clinical variables (electrocardiographic [ECG] changes and chest pain), 32 patients were evaluated with Doppler echocardiography during coronary angioplasty. Doppler indexes of left ventricular diastolic function included the ratios of peak early to late and peak early to mean diastolic velocities as well as the ratios of early to late and first third to total velocity integral (one-third filling fraction). All diastolic indexes showed significant impairment by 15 seconds after coronary occlusion (ratio peak early to late filling velocity: 1.11 versus 0.96, p less than 0.01; ratio peak early to mean filling velocity: 1.9 versus 1.7, p less than 0.01; ratio early to late velocity integral: 1.58 versus 1.25, p less than 0.01; one-third filling fraction: 41.2 versus 37.7, p less than 0.01). Left ventricular systolic function was evaluated during coronary occlusion both qualitatively, as assessed by the appearance of a new wall motion abnormality on two-dimensional echocardiography (mean 28.8 seconds), and quantitatively by measurement of systolic percent area change on the two-dimensional short-axis view as well as the Doppler echocardiographic stroke integral index. Systolic indexes did not show significant change until 30 seconds after balloon inflation (percent area change: 42.8 versus 29.2, p less than 0.01; stroke integral index: 11.04 versus 9.36, p less than 0.01). ECGs were performed at 15 second intervals.(ABSTRACT TRUNCATED AT 250 WORDS)

The aim of this multicenter pilot study was to evaluate the acute safety and efficacy of the dexamethasone-eluting stent (0.5 g/mm 2 of stent) implanted in patients with de novo single-vessel disease. This study included 71 patients, 42% of whom had unstable angina pectoris. An appropriately sized BiodivYsio Matrix Lo stent loaded with a total dexamethasone dose of 0.5 g/mm 2 of stent was used. Technical device success rate was 95%. Six-month MACE occurred in two patients (3.3%). Binary restenosis rate was 13.3%.

The study demonstrates that it is possible to achieve infarct vessel recanalization in the majority of late-entry patients with either thrombolytic therapy or angioplasty. Thrombolytic intervention had a favorable effect on prevention of cavity dilatation and left ventricular remodeling, but there are no late benefits on systolic function after thrombolysis or coronary angioplasty. The conclusions concerning overall potential benefit of applying late reperfusion therapy will require data from large-scale trials designed to assess mortality reduction.