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December 1, 1989Catheterization and Cardiovascular Diagnosis

Side branch occlusion during coronary angioplasty: Incidence, angiographic characteristics, and outcome

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Why the study?

What is the incidence, angiographic characteristics, and clinical outcome of side branch occlusion during percutaneous transluminal coronary angioplasty?

Population

4,800 consecutive patients undergoing percutaneous transluminal coronary angioplasty between January 1981…

Design

Cohort

Authors

RARohit AroraInnsbruck Medical UniversityRRRussell RaymondCleveland ClinicADAlexios P. DimasHygeia Hospital

Discussion

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Implication

Side branch occlusion warrants periprocedural MI vigilance; observational data extends complication profiles but leaves open optimal prevention strategies.

Key Points

  • To determine the incidence, angiographic characteristics, and clinical sequelae of side branch occlusion occurring during percutaneous transluminal coronary angioplasty.
  • Retrospectively analyzed coronary angiograms from 4,800 consecutive patients treated between January 1981 and December 1987.
  • Identified and evaluated 167 patients with 181 lesion sites involving occlusion of side branches greater than 1 mm in diameter.
  • Side branch occlusion occurred in 3% of patients (167 of 4,800), most frequently in branches with pre-existing disease (66%, 120 of 181) or originating within the primary arterial lesion (72%, 130 of 181).
  • Occlusion was located in diagonal (36%, 65/181), septal (27%, 49/181), left circumflex (22%, 40/181), and right coronary branches (15%, 27/181).
  • Myocardial infarction occurred in 14% of occlusion cases, and mechanical attempts to reopen the occluded branches succeeded in 75% of cases (27 of 36).

Structured PICO

What is the incidence, angiographic characteristics, and clinical outcome of side branch occlusion during percutaneous transluminal coronary angioplasty?

P
Population
4,800 consecutive patients undergoing percutaneous transluminal coronary angioplasty between January 1981 and December 1987, with a focus on 167 patients (3%) experiencing side branch occlusion (>1 mm).
I
Intervention
Percutaneous transluminal coronary angioplasty (PTCA)
O
Outcome
Incidence, angiographic characteristics, and sequelae of side branch occlusionsafety

Side branch occlusion during coronary angioplasty is uncommon (3%) but carries a 14% risk of myocardial infarction, though many occlusions can be successfully reopened.

Cite This Study

Arora et al. (1989) studied this question.

synapsesocial.com/papers/6a129af21d9aa3bb4e34687bhttps://doi.org/10.1002/ccd.1810180404
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Risk factors and clinical consequences of side branch occlusion in left anterior descending bifurcation percutaneous coronary intervention: a validation study of the V-RESOLVE score2025 · 2 citations
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  3. 3Predictors and complications of side branch occlusion after recanalization of chronic total occlusions complicated with bifurcation lesions2021 · 13 citations
  4. 4Structural and hemodynamic analysis for predicting side branch occlusion in coronary bifurcation interventions2025
  5. 5Structural and hemodynamic analysis for predicting side branch occlusion in coronary bifurcation interventions2025