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To assess the result of percutaneous transluminal coronary angioplasty (PTCA) of the very prortmal left anterior descending (LAD) Iesions, 153 consecutive patients undergoing PTCA of LAD were analyzed. The distance ofthe lesionfrom the origin of LAD was measuredin the right anterior oblique angiogram. Twenty two patients (group I) hadveryproximallesion( 0.5 cmfromthe origin), 39 patients ( group II) had intermediate proximal lesion ( 0.5 cm from the origin, but still before the first septal branch) and 92 patients (groupIII)hadmoredistallesion.Tandemlesionsnecessitating multipleballooninflationwereobservedin9(40.9Vo)patientsof group I, 1 1 (28.2 7o) patients of group II (excluding those already included in group I) and 23 (25 Vo) patients of group III (excluding those already included in groups I and II). Success rates were 20 (90.9 %); 3S (97.4 Vo) and 82 (89.1 Vo) respectively, in group I, II and III. Dffirences were statistically not significant. Extent of disease as well as degree and morphologic severity did not influence success. No complications occured in any patient of group I. Dissection of the main stem has not observed. One patient of group III developed acute infarction and one patient of group III died. We failed to cross chronic lotal occlusion in, respectively; 2, I and 9 patients of group I, II and III. PTCA of the very proximal I'AD can be performed safely with a high success rate.

Percutaneous transluminal coronary angioplasty of the very proximal left anterior descending coronary artery lesions