(Circulation. 1997;96:468-474.)
© 1997 American Heart Association, Inc.
Articles |
Late Regression of the Dilated Site After Coronary Angioplasty
A 5-Year Quantitative Angiographic Study
From Green Lane Hospital, Epsom, Auckland, New Zealand.
Correspondence to Dr John Ormiston, Cardiac Investigation Rooms, Green Lane Hospital, Epsom, Auckland 1003, New Zealand.
Background Limited data are available on the changes that
occur at the dilated site late after coronary angioplasty. The
aim of this study was to evaluate with quantitative angiography the
natural history of changes that occur in the dilated segment between
"early" (
6 months) and "late" (5 years) follow-up
after angioplasty.
Methods and Results Of 127 consecutive patients (174
lesions) with successful angioplasty, 125 underwent early angiography.
Three patients subsequently died, and 24 underwent
revascularization surgery or repeated angioplasty,
giving a study-eligible population of 98 patients. Quantitative
angiographic analysis was performed before and immediately
after angioplasty and at early and late follow-up in the study
population of 84 patients (115 lesions), which was 86% of
study-eligible patients. Mean lesion diameter stenosis
decreased from 36.3±14.2% at early to 29.6±13.5% at late follow-up
(P<.0001). No lesion developed late restenosis by
the 50% diameter loss criterion. Late regression was related to
stenosis severity at early angiography (r=-.58,
P<.001). Subgroups at early angiography of 40% to 49%
stenosis and 
50% stenosis showed significant
regression at late angiography.
Conclusions Lesion regression at the dilated site is common late after angioplasty. The more severe a stenosis is at early angiography, the more likely the chance that there will be late regression. A strategy of watchful waiting may be appropriate for patients with restenotic lesions of borderline severity.
Key Words: restenosis • angioplasty • atherosclerosis • prognosis
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