Percutaneous transluminal coronary angioplasty in unstable angina: comparison with stable angina.

Quigley, P. J.; Erwin, John P.; Maurer, B.; Walsh, Michael J.; Gearty, G.

doi:10.1136/hrt.55.3.227

Cited by 57 publications

(8 citation statements)

References 14 publications

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“…Although these data are consistent with those from some previous studies [4,5,7,9,12,18,19], they are not in agreement with two other reports which have indicated an increased risk of restenosis in patients suffering from unstable angina prior to the time of coronary angioplasty [10,17]. However, comparison between the few published reports on angioplasty for stable and unstable angina must be done with caution for a number of reasons.…”

Section: Incidence Of Restenosiscontrasting

confidence: 43%

“…Whereas some previous reports have indicated that angioplasty for unstable angina is associated with an increased risk of lesion recurrence as compared with stable angina [10,17], this has not been corroborated by others [4,5,7,9,12,18,19].…”

Section: Introductionmentioning

confidence: 69%

“…Increasing operator experience and technical innovations have made percutaneous transluminal coronary angioplasty (PTCA) a safe and successful treatment modality for patients with symptoms of either stable or unstable angina pectoris [1][2][3][4][5][6][7]. However, the long-term outcome of PTCA is still significantly curtailed by the so far unpredictable progression to recurrent stenosis in 12 to 48 percent of patients [4, 5, 8--15].…”

Section: Introductionmentioning

confidence: 99%

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Angioplasty for stable versus unstable angina pectoris: Are unstable patients more likely to get restenosis?

Luijten¹,

Beatt²,

Feyter³

et al. 1988

Int J Cardiac Imag

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Current evidence with regard to the possible association between clinical expression of coronary disease prior to the time of angioplasty, and the subsequent risk of restenosis following successful dilatation, remains inconclusive. To prospectively compare the incidence of restenosis in stable versus unstable angina pectoris patients, follow-up angiography was performed in 85 percent of patients from a consecutive series with a successful PTCA, irrespective of presence or absence of recurrent ischemic symptoms. Furthermore, changes in lesion severity were assessed quantitatively by an automated edge-detection technique rather than visual analysis. Employing such a study design and follow-up protocol, it was found that the incidence of restenosis in patients with stable coronary artery disease was similar to that of patients with unstable rest angina, irrespective of the type of angiographic definition used.

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Section: Incidence Of Restenosiscontrasting

confidence: 43%

Section: Introductionmentioning

confidence: 69%

Section: Introductionmentioning

confidence: 99%

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Angioplasty for stable versus unstable angina pectoris: Are unstable patients more likely to get restenosis?

Luijten¹,

Beatt²,

Feyter³

et al. 1988

Int J Cardiac Imag

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“…The coronary artery obstruction in patients with unstable angina is at risk of becoming a permanent occlusion leading to myocardial infarction or death [10,11]. It has now been shown that coronary angioplasty is relatively safe and can be performed with a high success rate in unstable angina that is either refractory to optimal pharmacological treatment [12][13][14] or is initially stabilized after treatment [15][16][17] (Table 1). The reported lower success rate of 63% to 76% was achieved with a nonsteerable dilatation catheter, whereas the initial success rate of 81% to 93% was achieved with a steerable dilatation catheter.…”

Section: Coronary Angioplasty For Initially Stabilized Unstable Anginmentioning

confidence: 99%

Indications for coronary angioplasty in acute myocardial ischemic syndromes

Feyter

Serruys

Hugenholtz

1988

Cardiovasc Drug Ther

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The role of coronary angioplasty for the treatment of patients with evolving myocardial infarction, unstable angina, and early postinfarction unstable angina is discussed. It has been shown that coronary angioplasty in patients with an evolving myocardial infarction is feasible and can be performed with a high initial success rate. The most beneficial timing of dilatation is still unclear, and acute reocclusion following coronary angioplasty remains a problem. Current data suggest that the left ventricular function is greater improved and peri-infarction ischemia is less with angioplasty when compared with sole thrombolytic treatment. Coronary angioplasty for unstable angina and early post-infarction unstable angina can be performed with a high initial success rate, but at an increased risk of major complications. Thus, coronary angioplasty has nowadays obtained a definitive place in the treatment of acute myocardial ischemic syndromes. Further research is needed to improve the initial and late results of coronary angioplasty, and additional randomized clinical studies are necessary to more accurately define the indications and timing of dilatation in these acutely ill patients.

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“…The primary success rate is similar to that after PTCA in patients with stable angina, but the major complication rate is higher in unstable patients, often because of the development of abrupt thrombotic occlusion resulting in acute myocardial infarction or emergency CABG. [10][11][12] Direct PTCA has been used to treat acute myocardial infarction and has had high initial success rates, but the incidence of abrupt thrombotic occlusion during the procedure, or shortly afterward, is higher than that for elective PTCA.13,14 When PTCA has been used acutely to reduce the residual stenosis in patients who initially received systemic thrombolytic therapy, the complication rates of performing emergency CABG and of death also have been increased, and the incidence of reocclusion in successfully dilated arteries has been 11-12.5%. [15][16][17] Patients with early postinfarction ischemia are known to be at high risk for reinfarction and death, '8,19 and PTCA has been used in this setting with high early success rates.…”

mentioning

confidence: 99%

Intracoronary urokinase for intracoronary thrombus accumulation complicating percutaneous transluminal coronary angioplasty in acute ischemic syndromes.

Schieman

Kozina

et al. 1990

Circulation

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Intracoronary urokinase was used to treat flow-limiting intracoronary thrombus accumulation that complicated successful percutaneous transluminal coronary angioplasty (PTCA) during acute ischemic syndromes in 48 patients who were followed up through the acute phase of their illness. The study group with 63% of all patients studied before discharge), and in no patient was there angiographic evidence of reocclusion, although two patients showed angiographic evidence of stenosis; improved vessel percent stenosis persisted, averaging 32±17%. In all patients studied, the coronary flow was TIMI grade 3 at follow-up. Thus, in patients with acute ischemic syndromes with flow-limiting intracoronary thrombus accumulation that complicated PTCA, intracoronary urokinase with repeated PTCA proved to be highly effective in restoring vessel patency and avoiding early complications. (Circulation 1990;82:2052-2060 T he acute ischemic syndromes of unstable angina pectoris, acute myocardial infarction, and postinfarction angina often share a common pathogenesis, with atherosclerotic plaque rup-*All editorial decisions for this article, including selection of reviewers and the final decision, were made by a guest editor. This procedure applies to all manuscripts with authors from the

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Percutaneous transluminal coronary angioplasty in unstable angina: comparison with stable angina.

Cited by 57 publications

References 14 publications

Angioplasty for stable versus unstable angina pectoris: Are unstable patients more likely to get restenosis?

Angioplasty for stable versus unstable angina pectoris: Are unstable patients more likely to get restenosis?

Indications for coronary angioplasty in acute myocardial ischemic syndromes

Intracoronary urokinase for intracoronary thrombus accumulation complicating percutaneous transluminal coronary angioplasty in acute ischemic syndromes.

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