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Early Outcome of PTCA in Totally Occluded Coronary Arteries
BACKGROUND: Since percutaneous transluminal coronary angioplasty (PTCA) was first introduced in 1977 by Gruentzig as a treatment for proximal short-segmental, non-calcified, concentric isolated coronary stenosis, it has been used with increasing frequency in patients of symptomatic coronary artery d...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Korean Association of Internal Medicine
1993
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4532077/ https://www.ncbi.nlm.nih.gov/pubmed/8268141 http://dx.doi.org/10.3904/kjim.1993.8.1.15 |
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author | Ahn, Young Keun Park, Joo Hyung Park, Jong Soo Lee, Myung Kon Jeong, Myung Ho Cho, Jeong Gwan Park, Jong Chun Kang, Jung Chaee |
author_facet | Ahn, Young Keun Park, Joo Hyung Park, Jong Soo Lee, Myung Kon Jeong, Myung Ho Cho, Jeong Gwan Park, Jong Chun Kang, Jung Chaee |
author_sort | Ahn, Young Keun |
collection | PubMed |
description | BACKGROUND: Since percutaneous transluminal coronary angioplasty (PTCA) was first introduced in 1977 by Gruentzig as a treatment for proximal short-segmental, non-calcified, concentric isolated coronary stenosis, it has been used with increasing frequency in patients of symptomatic coronary artery disease with broader indications, including patients with multi-vessel disease, unstable angina, acute myocardial infarction and totally occluded coronary arteries. Among these, total coronary occlusion constitutes a subdivision with specific features that require separate evaluation. The purpose of this study was to determine the initial results of PTCA for total coronary occlusion. METHODS: Thirty-five patients with manifested ischemic heart disease with totally occluded coronary arteries, documented by coronary angiogaphy, underwent recanalization procedure by PTCA between Jan. 1990 and Oct. 1991. RESULTS: Thirty-five patients were comprised of 20 acute myocardial infarction (MI), 7 old MI and 8 unstable angina. Eighteen (50.1%) patients had one major atherosclerosis risk factor and 10 (29.4%) had two or more. PTCA for total coronary artery occlusion was attempted in the left anterior descending artery (LAD) in 16 patients, right coronary artery (RCA) in 11, left circumflex artery (LCx) in 2 and protected left main in one. PTCA was successful in 23 patients (66%): LAD in 11/18 (61%) and RCA 11/14 (79%), showing significantly higher success rate with RCA than LAD (p<0.05). Primary success rate of PTCA in accordance with the duration of the total occlusion estimated on the basis of clinical and angiographic data was 71% (15/21) when less than two weeks, 63% (5/8) when between 2 to 12 weeks, and 50% (3/6) longer than 12 weeks, Mean duration of the total occlusion in successful PTCA was 1.4 months (range; 10 days-5 months) and, 1.7 months (range; 3 weeks-3 years) in failed PTCA. Diameter stenosis of the lesions was significantly decreased from 100% to 19.7% after successful PTCA. There was no death but 2 patients were complicated with coronary artery embolization occluding major distal branches. CONCLUSION: The study suggested that PTCA of total coronary artery occlusion can be performed safely and effectively in selected cases and might be more successful in the lesion with shorter duration of occlusion. |
format | Online Article Text |
id | pubmed-4532077 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 1993 |
publisher | Korean Association of Internal Medicine |
record_format | MEDLINE/PubMed |
spelling | pubmed-45320772015-10-02 Early Outcome of PTCA in Totally Occluded Coronary Arteries Ahn, Young Keun Park, Joo Hyung Park, Jong Soo Lee, Myung Kon Jeong, Myung Ho Cho, Jeong Gwan Park, Jong Chun Kang, Jung Chaee Korean J Intern Med Original Article BACKGROUND: Since percutaneous transluminal coronary angioplasty (PTCA) was first introduced in 1977 by Gruentzig as a treatment for proximal short-segmental, non-calcified, concentric isolated coronary stenosis, it has been used with increasing frequency in patients of symptomatic coronary artery disease with broader indications, including patients with multi-vessel disease, unstable angina, acute myocardial infarction and totally occluded coronary arteries. Among these, total coronary occlusion constitutes a subdivision with specific features that require separate evaluation. The purpose of this study was to determine the initial results of PTCA for total coronary occlusion. METHODS: Thirty-five patients with manifested ischemic heart disease with totally occluded coronary arteries, documented by coronary angiogaphy, underwent recanalization procedure by PTCA between Jan. 1990 and Oct. 1991. RESULTS: Thirty-five patients were comprised of 20 acute myocardial infarction (MI), 7 old MI and 8 unstable angina. Eighteen (50.1%) patients had one major atherosclerosis risk factor and 10 (29.4%) had two or more. PTCA for total coronary artery occlusion was attempted in the left anterior descending artery (LAD) in 16 patients, right coronary artery (RCA) in 11, left circumflex artery (LCx) in 2 and protected left main in one. PTCA was successful in 23 patients (66%): LAD in 11/18 (61%) and RCA 11/14 (79%), showing significantly higher success rate with RCA than LAD (p<0.05). Primary success rate of PTCA in accordance with the duration of the total occlusion estimated on the basis of clinical and angiographic data was 71% (15/21) when less than two weeks, 63% (5/8) when between 2 to 12 weeks, and 50% (3/6) longer than 12 weeks, Mean duration of the total occlusion in successful PTCA was 1.4 months (range; 10 days-5 months) and, 1.7 months (range; 3 weeks-3 years) in failed PTCA. Diameter stenosis of the lesions was significantly decreased from 100% to 19.7% after successful PTCA. There was no death but 2 patients were complicated with coronary artery embolization occluding major distal branches. CONCLUSION: The study suggested that PTCA of total coronary artery occlusion can be performed safely and effectively in selected cases and might be more successful in the lesion with shorter duration of occlusion. Korean Association of Internal Medicine 1993-01 /pmc/articles/PMC4532077/ /pubmed/8268141 http://dx.doi.org/10.3904/kjim.1993.8.1.15 Text en Copyright © 1993 The Korean Association of Internal Medicine This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Ahn, Young Keun Park, Joo Hyung Park, Jong Soo Lee, Myung Kon Jeong, Myung Ho Cho, Jeong Gwan Park, Jong Chun Kang, Jung Chaee Early Outcome of PTCA in Totally Occluded Coronary Arteries |
title | Early Outcome of PTCA in Totally Occluded Coronary Arteries |
title_full | Early Outcome of PTCA in Totally Occluded Coronary Arteries |
title_fullStr | Early Outcome of PTCA in Totally Occluded Coronary Arteries |
title_full_unstemmed | Early Outcome of PTCA in Totally Occluded Coronary Arteries |
title_short | Early Outcome of PTCA in Totally Occluded Coronary Arteries |
title_sort | early outcome of ptca in totally occluded coronary arteries |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4532077/ https://www.ncbi.nlm.nih.gov/pubmed/8268141 http://dx.doi.org/10.3904/kjim.1993.8.1.15 |
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