Long-term follow-up of 100 patients with left anterior descending artery lesions treated with percutaneous transluminal coronary angioplasty.

In order to analyse late outcome, we reviewed the data on the first 100 patients who underwent percutaneous transluminal coronary angioplasty (PTCA) of the left anterior descending artery (LAD) in our institution. Their ages ranged between 40.0 and 82.3 years (mean 66.6, males 75%, females 25%). All patients were treated with the non-steerable system between September 1980 and February 1983, and followed up for 6.2-9.6 years (mean 8.5 years). The primary success rate was 73%. We were unable to cross the lesion in 19%, and 8% of the patients required emergency bypass surgery because of acute occlusion or dissection. Elective bypass surgery was required in 18% of the patients. The clinical restenosis rate was 22%. Risk factors in this patient group were: smoking 66%; hypertension 37%; elevated serum cholesterol 32% and diabetes mellitus in 7%. After an initially successful PTCA, 12 out of 73 patients required a second PTCA of the same vessel because of restenosis and three, PTCA of a new lesion in another vessel because of recurrence of angina. Fifty-four patients were asymptomatic during the follow-up period of 8.5 years. Ninety-four of the 100 patients are still alive. Canadian Heart Association anginal classification of the study group was: class 0: 80 patients; class I: 11 patients; class II: three patients; class III and IV: no patient. Six patients died, there were four non-cardiac deaths because of cancer; one patient died 24 h after a myocardial infarction as a result of cardiogenic shock and ventricular septal rupture and one died suddenly 6 years after the initial PTCA.(ABSTRACT TRUNCATED AT 250 WORDS)