Percutaneous transluminal coronary angioplasty for angina pectoris after a non-Q-wave acute myocardial infarction

Suryapranata, Harry; Beatt, Kevin J.; Feyter, Pim J. de; Verrostte, J. M.; Brand, Marcel van den; Zijlstra, Felix; Serruys, Patrick W.

doi:10.1016/0002-9149(88)90923-x

Cited by 25 publications

(1 citation statement)

References 23 publications

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“…Dialysis-associated arthropathy has been recognized for 10 years, but is still without successful cure or prevention measures, and represents a major obstacle to successful prolonged dialysis. Although no direct association has been established between the dialysis process and its development, there remains some suspicion that the prevention of dialysate endotoxin contamination and the use of a biocompatible membrane with greater solute clearance will contribute to its prevention; 16 however, these measures will entail increased costs.…”

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Short‐term and long‐term benefits of coronary angioplasty in unstable angina pectoris

Wilkes

Barin

Lister

et al. 1990

Medical Journal of Australia

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Primary coronary angioplasty was attempted in 288 patients (206 men and 82 women) who presented with stable (50%) or unstable (50%) angina pectoris. The success rates of angioplasty and the subsequent revascularization requirements in these two angina categories were compared during a one year prospective follow‐up. The site and distribution of coronary artery stenoses did not differ between the categories. Three hundred and five dilatations were attempted (149 in 144 patients with unstable angina and 156 in 144 patients with stable angina). Of these procedures, 265 (87%) were technically successful — 133 (89%) in 128 patients with unstable angina and 132 (85%) in 120 patients with stable angina. Lower success rates were achieved in 29 attempted dilatations of vessels with chronic total occlusion (19 successful [66%], P = 0.002) and in 19 patients who presented with unstable angina after recent (within two weeks) infarction (10 patients with successful angioplasty, [53%], P < 0.0001). Subsequent revascularization requirements after an initially successful angioplasty in 57 patients were greater in unstable (36 patients) than in stable angina (21 patients; P= 0.05) and reflected the greater frequency of repeat angioplasty in patients with unstable angina (22 patients) compared with those with stable angina (10 patients; P = 0.04) among patients with recurrent symptoms. At one year, 245 patients (85%) — 121 treated for unstable angina and 124 treated for stable angina — experienced no angina during normal daily activities. We conclude that a primary angioplasty success rate of 89% can be achieved in patients with unstable angina pectoris but this rate is significantly lower in patients presenting after recent infarction. Repeat angioplasty for recurrent symptoms after a successful primary procedure is required more frequently in patients presenting with unstable angina.

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confidence: 99%

Short‐term and long‐term benefits of coronary angioplasty in unstable angina pectoris

Wilkes

Barin

Lister

et al. 1990

Medical Journal of Australia

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Management of complicated coronary angioplasty by intracoronary urokinase and immediate re‐angioplasty

Verna

Boscarini

et al. 1990

Cathet. Cardiovasc. Diagn.

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Percutaneous transluminal coronary angioplasty was complicated by acute coronary occlusion, dissection of the arterial wall, or angiographic evidence of intraluminal thrombosis in 33 high-risk patients from 153 consecutive angioplasty procedures (21.5%). Ten patients (group I) were managed with nitroglycerin (0.2 to 0.4 mg i.c.) and repeated attempts at mechanical guide wire recanalization or dilation, but they did not receive thrombolytic therapy. In the remaining 23 patients (group II), intracoronary urokinase (100,000 to 360,000 U.I.) was administered over 15-20 min after onset of coronary occlusion or thrombosis and continued during attempts at repeated dilation of the stenosis. The incidence of sudden coronary artery occlusion was 70% in group I patients and 52% in group II. The angiographic evidence of thrombus formation was observed in a higher, but not significant, proportion of group II patients (65%) as compared with group I (30%). The incidence of intimal tearing or dissection was similar in the two groups of patients (40 vs. 34.7%). The overall final success rate of the complicated angioplasty series was 48% (6/33). However, the success rate was lower (10%) in group I than in group II patients (10 vs. 65%; P less than 0.005), and the frequency of emergency coronary artery bypass grafting was lower in group II patients (13 vs. 60%; P = 0.01), suggesting that thrombolytic therapy with urokinase may be effective in the management of acute coronary occlusion and thromboembolic complications of coronary angioplasty.

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Comparison of results of intracoronary stenting in patients with unstable vs. stable angina

Malosky

Hirshfeld

Herrmann

1994

Cathet. Cardiovasc. Diagn.

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Percutaneous transluminal coronary angioplasty (PTCA) has higher complication and restenosis rates when performed in the setting of unstable angina. Balloon-expandable intracoronary stenting is a new technique with the potential to improve the results of PTCA. In order to determine whether stenting is associated with a poorer outcome in patients with unstable angina, we retrospectively examined our experience with the Palmaz-Schatz balloon-expandable intracoronary stent in 105 patients. Patients were divided into 2 groups on the basis of symptoms at the time of stent insertion: group I (n = 57) had stable angina pectoris, and group II (n = 48) had unstable angina defined as pain at rest despite antianginal therapy (Braunwald class II, III). Initial (30-d) and final (6-mo) success rates were defined as stent insertion without myocardial infarction, need for bypass surgery, death, and significant angina. Baseline characteristics were similar, although the patients with unstable symptoms were older, more likely to be female, and had a higher incidence of postinfarction angina. A total of 136 stents were successfully delivered to 97 target sites in 92% of patients. Major complications occurred in 4 patients (4%) and were due to subacute thrombosis in 3 of them. There were no differences in complication rates between patients receiving stents electively with stable vs. unstable symptoms (2% vs. 6%, p = NS). Six-mo. follow-up status was ascertained in 96% of patients and revealed overall clinical success in 83% with angiographic restenosis (> or = 50% stenosis) in 28% of patients. There were no significant differences between groups in rates of restenosis, follow-up angina class, or overall clinical success.(ABSTRACT TRUNCATED AT 250 WORDS)

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Percutaneous transluminal coronary angioplasty for angina pectoris after a non-Q-wave acute myocardial infarction

Cited by 25 publications

References 23 publications

Short‐term and long‐term benefits of coronary angioplasty in unstable angina pectoris

Short‐term and long‐term benefits of coronary angioplasty in unstable angina pectoris

Management of complicated coronary angioplasty by intracoronary urokinase and immediate re‐angioplasty

Comparison of results of intracoronary stenting in patients with unstable vs. stable angina

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