Advertisement

Effect of investigator experience on percutaneous transluminal coronary angioplasty

      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      The NHLBI PTCA Registry collected clinical data on 3, 101 PTCA procedures performed at 105 clinical centers between September 1977 and September 1981. To investigate the “learning curve” from introduction through the early application of this new therapy for revascularization, success rates and complication rates were examined by calendar year and according to investigator experience. Success rates improved by calendar year, from 54% in 1979 to 66% in 1981. Investigators with fewer than 50 cases had a success rate of 55%. After an investigator had performed 150 procedures, the success rate was 77%. The increase in success rate was largely the result of a dramatic increase in the ability to cross the narrowing with the catheter, and was accounted for by experience and improved equipment. Patient selection for PTCA was characterized by sex, age, previous CABG, number of diseased coronary arteries and stable Canadian Heart classification over time. Reflecting the increase in the success rate was the decrease in the need to perform elective CABG. Emergency CABG, death and MI rates were low (1% mortality, 5% nonfatal MI) and did not change significantly with time or with investigator experience.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Cardiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Gruentzig A
        Transluminal dilatation of coronary artery stenosis.
        Lancet. 1978; 1: 263
        • Gruentzig AR
        • Senning A
        • Siegenthaler WE
        Non-operative dilatation of coronary artery stenosis. Percutaneous transluminal coronary angioplasty.
        N Engl J Med. 1979; 301: 61-68
        • Dorros B
        • Stertzer SH
        • Bruno MS
        • Kaltenbach M
        • Myler RK
        • Spring DA
        The brachial artery method to transluminal coronary angioplasty.
        Cathet Cardiovasc Diag. 1982; 8: 233-242
        • Balm DS
        Percutaneous transluminal coronary angioplasty: analysis of unsuccessful procedures as a guide toward improved results.
        Cardiovasc Intervent Radiol. 1982; 5: 186-193
        • Kent K
        • Bentivogllo L
        • Block P
        • Cowley M
        • Dorros G
        • Gosselin A
        • Gruentzig A
        • Myler R
        • Simpson J
        • Stertzer S
        • Williams D
        • Fisher L
        • Gillespie M
        • Detre K
        • Kelsey S
        • Mullin S
        • Mock M
        Percutaneous transluminal coronary angioplasty: report from the National Heart, Lung, and Blood Institute.
        Am J Cardiol. 1982; 49: 2011-2020
        • Fleiss JL
        Statistical Methods for Rates and Proportions.
        in: 2nd ed. Wiley & Sons, New York1981: 143-146
        • Levy R
        • Mock M
        • Willman V
        • Frommer P
        Percutaneous transluminal coronary angioplasty.
        N Engl J Med. 1979; 301: 101
      1. Proceedings of the Workshop on Percutaneous Transluminal Coronary Angioplasty, June 15–16, 1979US Dept. HEW, NHLBI. Publ. No. 802030. March 1980: 9-88
        • Williams DO
        • Gruentzig A
        • Kent K
        • Myler R
        • Stertzer S
        • Bentivoglio L
        • Bourassa M
        • Block P
        • Cowley M
        • Detre K
        • Dorros G.
        • Gosselin A
        • Simpson J
        • Passamani E
        • Mullin S
        Guidelines for the performance of percutaneous transluminal coronary angioplasty.
        Circulation. 1982; 66: 693-694
        • Dorros G
        • Cowley M
        • Simpson J
        • Bentivoglio L
        • Block P
        • Bourassa M
        • Detre K
        • Gosselin A
        • Gruentzig A
        • Kelsey S
        • Kent K
        • Mock M
        • Mullin S
        • Myler R
        • Passamani E
        • Stertzer S
        • Williams D
        Percutaneous transluminal coronary angioplasty: a report of complications from the National Heart, Lung and Blood Institute PTCA registry.
        Circulation. 1983; 67: 723-730
        • Meier B
        • Gruentzig AR
        PTCA learning curve: skill, technology or patient selection?.
        Am J Cardiol. 1984; 53: 0000-0000