Complications Associated with PTCA

Abstract

Percutaneous transluminal coronary angioplasty (PTCA) has proven to be a safe and effective treatment of selected patients with coronary artery occlusive disease. Initially, PTCA was used to treat proximal, isolated coronary stenosis in patients with single-vessel disease [1]. Subsequently, the technique of PTCA has been used as an investigative technique in patients with more complex coronary artery disease (e.g., when there is a history of prior bypass surgery, multivessel coronary disease, disease in geriatric patients, and disease necessitating multiple dilatations). In March 1979, the United States National Heart, Lung, and Blood Institute (NHLBI) established an international registry of PTCA patients. The purpose of the registry was to accumulate baseline and followup data to facilitate evaluation of the safety, effectiveness, and long-term outcome of this technique. In 1981, the initial report of the NHLBI PTCA Registry [2] discussed coronary angioplasty in general, and a subsequent communication in 1983 [3] concerned the complications occurring in the first 1500 patients enrolled in the Registry. The complication report was subsequently modified by reports [4–6] analyzing the complications which occurred in the 3079 patients from 105 contributing centers enrolled in the PTCA Registry. This communication will summarize the NHLBI PTCA Registry complications data, with particular emphasis on analysis of the acute coronary vascular and ischemic events, the inpatient mortality, and the patients who underwent emergency bypass surgery.