Does repeat percutaneous transluminal coronary angioplasty have similar success and complication rates as the initial procedure in patients with symptomatic restenosis?
Repeat balloon coronary angioplasty for symptomatic restenosis has similar success and complication rates to the initial procedure, but carries significant risks including a 12% rate of emergency bypass surgery.
Of 694 patients in whom percutaneous transluminal coronary angioplasty was attempted for palliation of symptomatic coronary artery disease, 74 subsequently underwent a repeat procedure because of symptomatic restenosis. The repeat dilatation was successful in 55 patients (74%). The primary success rate and the incidence of major complications were similar for initial and repeat procedures. Complications of the repeat procedure included major dissection (14%), acute occlusion (7%) and emergency coronary bypass surgery (12%). After a mean follow-up period of 113 weeks (range, 15-309 weeks), 33 patients (60%) were asymptomatic; angina recurred in 22 (40%). In our hands, the success rate, complication rate, and long-term results of repeat percutaneous transluminal coronary angioplasty were similar to those associated with the initial procedure.
Sugrue et al. (1987) studied this question.