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Complex coronary angioplasty: Multiple coronary dilatations

  • Gerald Dorros
    Correspondence
    Address for reprints: Gerald Dorros, MD, Assistant Clinical Professor, Medical College of Wisconsin, 811 East Wisconsin Avenue, #930, Milwaukee, Wisconsin 53202.
    Affiliations
    From the Department of Cardiology, St. Luke's Hospital, Milwaukee, Wisconsin USA

    From the Department of Cardiology, Medical College of Wisconsin, Milwaukee, Wisconsin USA
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  • Simon H. Stertzer
    Affiliations
    From the Department of Cardiology, St. Luke's Hospital, Milwaukee, Wisconsin USA

    From the Department of Cardiology, Medical College of Wisconsin, Milwaukee, Wisconsin USA
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  • Michael J. Cowley
    Affiliations
    From the Department of Cardiology, St. Luke's Hospital, Milwaukee, Wisconsin USA

    From the Department of Cardiology, Medical College of Wisconsin, Milwaukee, Wisconsin USA
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  • Richard K. Myler
    Affiliations
    From the Department of Cardiology, St. Luke's Hospital, Milwaukee, Wisconsin USA

    From the Department of Cardiology, Medical College of Wisconsin, Milwaukee, Wisconsin USA
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      Abstract

      Selected patients underwent PTCA of multiple stenoses in different vessels or in the same vessel. Three hundred nine patients underwent 685 PTCA procedures in various combinations of arterial and vein graft stenoses. A multiple dilatation procedure was defined as successful when all lesions attempted were successfully dilated, or when the considered-critical-stenosis was successfully dilated and this resulted in a patient clinical improvement. Angiographic success was achieved in 599 of 685 lesions attempted (87.4%) and in 285 of 309 patients (92.2%). Complications included a mortality rate of 1.0%, an MI rate of 4.2% per patient and 1.9% per lesion attempted, and a 3.6% incidence of emergency CABG. Follow-up data show that 58 patients (20.4%) had clinical evidence of a lesion recurrence, and that 92.5% (37 of 40 patients) who underwent repeat angioplasty had a successful procedure. A sustained clinical improvement was obtained in 264 of 309 patients (85.4%). The data indicate that multiple dilatations are feasible with good success rates and acceptable complication rates. Further evaluation of this extended application of PTCA is needed to clearly establish its role in the therapy of CAD.
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