Coronary angioplasty for chronic total occlusion reduces the need for subsequent coronary bypass surgery

Percutaneous transluminal coronary angioplasty (PTCA), a procedure in which a balloon catheter is used to widen constricted coronary arteries, was originally used in cases where arteries were narrowed but not totally blocked. Improvements in technology and operator skill have extended the use of PTCA to the treatment of totally occluded arteries. The outcomes of 44 patients with total occlusion of a coronary artery who underwent PTCA were evaluated. The short-term success rate of the procedure, defined as restoration of blood flow with greater than 50 percent of the vessel's interior diameter restored, was 59 percent. Follow-up among the successfully treated patients showed recurrence of constriction in 65 percent, almost half of whom had no symptoms of constriction. More patients among the initially unsuccessfully treated group had coronary bypass surgery. One third of the patients who had an initially successfully procedure had a second PTCA. The study indicates that although repeat PTCA may be needed in patients with total coronary occlusions, the procedure leads to a reduction in the need for bypass surgery for symptom control. (Consumer Summary produced by Reliance Medical Information, Inc.)