Angiographic findings when chest pain recurs after successful percutaneous transluminal coronary angioplasty

Angiographic and clinical characteristics of 102 consecutive patients who underwent coronary cineangiography for assessment of recurrent angina pectoris after successful percutaneous transluminal coronary angioplasty (PTCA) were reviewed. Based on angiographic findings, patients were classified as having restenosis (n = 63), development of new, significant coronary stenosis (n = 15), incomplete revascularization (n = 9) or no significant coronary artery disease (n = 15). Eighteen clinical and technical characteristics of the study group were analyzed as predictors of angiographic outcome. The groups did not differ in terms of age, gender, number of inflations performed, peak inflation pressure or in the pre- or post-PTCA stenosis or gradient. The time from PTCA to onset of recurrent angina was the most powerful predictor of angiographic outcome. Patients in whom symptoms developed within 1 month of PTCA usually had incomplete revascularization or no coronary narrowing. Restenosis was the most common explanation for chest pain 1 to 6 months after PTCA. Angina recurring more than 6 months after PTCA was usually due to development of new, significant coronary artery narrowings.