Frequency in nonangioplasty patients of morphologic findings reported in coronary arteries treated with transluminal angioplasty.

The coronary arteries from 70 consecutive patients in whom percutaneous transluminal angioplasty (PTA) had not been performed during life were examined at necropsy for findings that have been previously described in patients or animals treated with PTA. In 33 (49%) of the 70 patients, 1 or more findings identical to those observed in necropsy studies of PTA-treated arteries were observed: "plaque fractures" in 31 (44%), "dissection clefts" in 26 (33%), and extensive medial thinning in 40 (57%). Observations in these 70 patients indicate that findings previously described in PTA-treated patients cannot necessarily be assumed to represent the results of PTA. The fact that improved vessel patency may be seen in the absence as well as the presence of such lesions precludes firm assurance that such lesions are the sole basis for successful angioplasty.