PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY IN PATIENTS GREATER-THAN-OR-EQUAL-TO 5 YEARS AFTER THEIR LAST CORONARY-BYPASS GRAFT-SURGERY

Angioplasty (PTCA) was successfully performed in 257 of 304 patients (85%) ≥ 5 years after their last bypass surgery. A lesion was successfully dilated in 496 of 566 vessels attempted (88%): 332/386 coronary arteries (86%) and 164/180 vein grafts (91%). Significant complications included: 8 (2.6%) mortalities, 4 (1.3%) emergency surgeries, 13 (4.3%) Q‐wave myocardial infarctions, and 14 (4.6%) distal embolizations. Distal embolization occurred in 13/180 (7%) vein graft lesions dilated and usually resulted in a non‐Q‐wave infarction (4/13 distal embolizations). A second PTCA was performed on 89 (35%) patients: 44% of them had lesion recurrence; 20% a new lesion requiring dilatation; and 30% both recurrence and new lesion. Follow‐up (mean 3.7 years) revealed 78% of patients having an improved anginal status, and 58% no angina. The cumulative probability of survival at 60 months was 88± 3%. Angioplasty can be effectively employed in patients ≥ 5 years remote from their last bypass surgery in native arteries or saphenous vein grafts with good procedural and long‐term success. Vein graft age inherently does not appear to be a contraindication to angioplasty. Copyright © 1990 Wiley Periodicals, Inc.