Circulation, Vol 67, 723-730, Copyright © 1983 by American Heart Association
G Dorros, MJ Cowley, J Simpson, LG Bentivoglio, PC Block, M Bourassa, K Detre, AJ Gosselin, AR Gruntzig, SF Kelsey, KM Kent, MB Mock, SM Mullin, RK Myler, ER Passamani, SH Stertzer and DO Williams
The complications reported in the first 1500 patients enrolled in the
National Heart, Lung, and Blood Institute Percutaneous Transluminal
Coronary Angioplasty (PTCA) Registry are analyzed. Data were contributed
from 73 centers between September 1977 and April 1981. PTCA was successful
in 63% of attempts. Five hundred forty-three in-hospital complications
occurred in 314 patients (21%). The most frequent complications were
prolonged angina in 121, myocardial infarction (MI) in 72, and coronary
occlusion in 70. One hundred thirty-eight patients (9.2%) had major
complications (MI, emergency surgery or in-hospital death). One hundred two
patients (6.8%) required emergency surgery, usually for coronary dissection
or coronary occlusion. Sixteen patients (1.1%) died in-hospital; the
mortality rate was 0.85% in patients with one-vessel disease and 1.9% in
those with multivessel disease. The mortality rate was significantly higher
in patients who had had bypass surgery (p less than 0.001). Nonfatal
complications were significantly influenced by the presence of unstable
angina (p less than 0.001) and initial lesion severity greater than 90%
diameter stenosis (p less than 0.001). This report delineates and assesses
the complications encountered with PTCA during its initial 3 1/2-year
clinical experience. These results support the relative safety of PTCA as a
method of nonsurgical myocardial revascularization in carefully selected
patients.
ARTICLES
Percutaneous transluminal coronary angioplasty: report of complications from the National Heart, Lung, and Blood Institute PTCA Registry
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