PTCA at first sight: angioplasty based on video only

The results of 326 coronary angioplasties (PTCAs) performed during a first diagnostic angiography and based on video images only (PTCA at first sight, Group I) are compared with those of 756 PTCAs done during the same time period in patients with a previous cine-film and therefore a known or predictable coronary anatomy (Group II). Group I patients had more single vessel disease (74% versus 58%, p less than 0.001), single vessel PTCA (93% versus 84%, p<0.001), unstable angina (54% versus 28%, p less than 0.001), recent myocardial infarction (66% versus 37%, p less than 0.001), and total occlusion PTCA (29% versus 19%, p<0.01). On the other hand, they had less severe stable angina (mean New York Heart Association class 1.3+/-1.2 versus 1.8+/-1.4, p less than 0.001), less advanced disease (average of 1.3+/-0.5 versus 1.5+/-0.7 diseased vessels, p less than 0.001) and worse left ventricular ejection fraction (61+/-12% versus 63+/-12%, p less than 0.01). The angiographic and clinical success rates were 90% and 84% in Group I and 92% and 87% in Group II respectively, (p=NS). Complication rates were not statistically different between the groups (Q-wave myocardial infarction 2% versus 3%, non Q-wave myocardial infarction 4% in both groups, emergency surgery 0.3% versus 0.8% and inhospital mortality 0.9% for both groups). In selected patients, coronary angioplasty can be performed safely and effectively during a first coronary angiography based on video images exclusively.