Open AccessComplete Myocardial Revascularization by Single Session Triple Vessel Percutaneous Coronary Angioplasty and Provisional Stenting
Author(s) -
WACINSKI PIOTR,
URBAN PHILIP,
CHATELAIN PASCAL,
BACCHIOCCHISUILEN CAROLINE,
OLIVAL JOSE RAMOS,
DORSAZ PIERREANDRÉ
Publication year - 1999
Publication title -
journal of interventional cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.764
H-Index - 51
eISSN - 1540-8183
pISSN - 0896-4327
DOI - 10.1111/j.1540-8183.1999.tb00258.x
Subject(s) - medicine , angioplasty , cardiology , myocardial infarction , stent , balloon , right coronary artery , circumflex , revascularization , surgery , ejection fraction , unstable angina , artery , heart failure , coronary angiography
Background: Although availability of stents has made percutaneous transluminal coronary angioplasty (PTCA) safer, single vessel angioplasty still represents 90% of procedures performed today. We report our initial experience with single session triple vessel angioplasty, using stents as needed to improve suboptimal balloon results. Patients: Fourteen patients (12 men, 85%), aged 67 ± 19 years were treated. All had triple vessel disease and angina. Mean left ventricular ejection fraction was 61%± 8%. Results: PTCA was attempted in all three coronaries or one of their major branches during the same procedure. Seventeen target lesions were in the left anterior descending coronary artery, 2 in a diagonal branch, 11 in the left circumflex, 2 in a marginal branch, 13 in the right coronary artery, 3 in the posterior descending, and 1 a saphenous vein graft. PTCA of 3.5 ± 0.7 sites/procedure was attempted. The success rate was 13 (93%) of 14 patients and 47 (96%) of 49 lesions. Thirty‐four (69%) lesions were treated by implantation of one or several stents, and 10 (71%) of 14 patients received at least one stent. Hospital stay duration was 4 ± 2 days. One patient required repeat PTCA to treat subacute stent thrombosis 2 days after the procedure (creatine kinase [CK] peak < 2 times upper limit of normal). There were no in‐hospital deaths, Q‐wave infarction, or need for coronary artery bypass grafting (CABC). After a median follow‐up period of 24 months (range 3–102), one (7%) patient had died of a noncardiac cause, three (21 %) had required repeat PTCA for restenosis in previously dilated lesions, and none had suffered a myocardial infarction. At follow‐up, the median angina class was I (range I‐II). Conclusion: For selected patients with three vessel disease, complete revascularization by single session PTCA and provisional stenting as needed is feasible, and is associated with a low rate of short‐ and long‐term complications when successfully performed.