Coronary balloon angioplasty for elderly patients with severe angina.

From February 1983 to December 1986, 65 angioplasty procedures were attempted in 51 patients aged 65 or more. All had angina refractory to medical treatment and 89% of procedures were performed in patients in Canadian Cardiovascular Society angina class III or IV. Sixty eight per cent of patients had multivessel disease. Angioplasty was attempted on a single vessel in 52 instances (80%) and on multiple vessels in 13 (20%). The initial success rate was 75% for stenosis and 44% for occlusion. No attempt was made to treat all visible lesions in every case. At least one major complication occurred in 6.2% of the procedures: Q wave infarction in 4.6%, emergency surgery in 4.6%, and death in 4.6%. After a median follow up of four months (range 1-31) 37% of the patients in whom the procedure was initially successful were asymptomatic and 76% were improved by at least one Canadian Cardiovascular Society angina class. Angiographic restenosis occurred in 28% of treated lesions and 39% of patients had at least one recurrent stenosis. Among the patients with an initially successful procedure, 11% needed surgical revascularisation during the follow up period compared with 50% of those with a failed angioplasty. Balloon coronary angioplasty can be an effective form of treatment for the relief of severe angina in elderly patients.