Recurrence rate after successful coronary angioplasty

Among 356 consecutive patients with successful TCA performedbetween October 1977 and June 1983 follow-up angiograms wereperformed in 333 patients (94%). A total of 439 follow-up angiogramsat 1–48 (average 5.6) months after successful angioplastywere analysed. Restenosis rate was 12% if defined as remaining widening ofless than 20% compared with the situation before angioplasty.It was 16% if defined as loss of at least half of the initialgain in luminal diameter, and 17% if defined as increase fromimmediate post-TCA-stenosis of 30% or the loss of at least halfof the initial gain in luminal diameter. This value droppedto 15% if the subgroup of 30 patients with second TCA and of14 patients with dilatation of an aortocoronary bypass stenosiswere excluded; in both subgroups recurrence rate was higher(33% and 45%, respectively). The observed restenosis rate isless than 50% of that reported by the PTCA registry of the NHLBI.Several factors can possibly be responsible for the reductionin restenosis rate: selection of patients; technique of TCA;medical treatment during and after TCA; modification of riskfactors, compliance of patients; unknown factors. Long-term medical treatment with acetyl salicylic acid, nitratesand calcium blockers in high doses is considered to be mostprobably responsible for the favourable results.