[Percutaneous transluminal coronary angioplasty: relationship between the characteristics of the lesions and the immediate outcome].

In order to clarify the relationship between characteristics of lesions and the immediate outcome after percutaneous transluminal coronary angioplasty (PTCA) in Chinese patients, 170 cases of PTCA performed in this institution from December 1986 to July 1993 were analysed. There were 149 cases of angina pectoris, 75 complicated with old myocardial infarction; 21 cases of acute myocardial infarction (AMI) including 8 complicated with cardiogenic shock, PTCAs were performed under assistance of IABP in 4 and under assistance of centrifugal pump in 1.236 lesions, including 15 lesions of total occlusion in AMI, 27 of chronic total occlusion and 9 lesions in bifurcation using double balloon technique, were attempted to be dilated. 213 (90.3%) of 236 lesions were successfully dilated. According to the standard set by the report of ACC/AHA task force, the success rate in type A lesions was 47/48 (97.9%), in type B lesions 136/151 (90.1%) and in type C lesions 30/37 (81.1%). The success rate in type A lesions was significantly higher than that in type C lesions (P < 0.01). In 7 of 8 patients with cardiogenic shock complicating AMI, PTCA was successful. 4 of the 7 survived. The major factors for failure in dilatation included chronic total occlusion, excessive tortuosity of proximal segment, eccentric and tubular lesions, etc. Acute occlusion occurred in 2 cases with type C and 1 with type B lesion, one patient died after 24h of emergency CABG. In one patient complicated with acute closure and 2 with threatened closure Gianturrco-Roubin stents were implanted and the patency of the vessels were maintained.(ABSTRACT TRUNCATED AT 250 WORDS)