Percutaneous transluminal coronary angioplasty as palliation for patients considered poor surgical candidates.

Published

Journal Article

Thirty-one patients with angina inadequately controlled by medical therapy, but who were poor surgical candidates because of advanced age and poor general condition, or because of depressed left ventricular function, had percutaneous transluminal coronary angioplasty (PTCA). These high-risk patients were identified prospectively, and coronary artery bypass surgery (CABS) was planned only in the event of arterial occlusion and chest pain. PTCA was successful in 11 of 17 (65%) high-risk geriatric patients, in 11 of 12 (92%) patients with left ventricular ejection fraction less than 40%, and in two additional patients having PTCA without surgical stand-by because of technically difficult vascular anatomy for CABS. There were no PTCA-related deaths; three of the 31 high-risk patients had emergency surgery because of arterial occlusion, and the remaining four patients with PTCA failure remain on medical therapy for angina. The clinical course of the 31 high-risk patients was similar to that of 155 patients having PTCA during the study period who were considered good candidates for either PTCA or CABS. PTCA may thus be considered an intermediate, palliative procedure for patients with inadequate control of ischemic symptoms who are poor surgical candidates.

Full Text

Duke Authors

Cited Authors

  • Taylor, GJ; Rabinovich, E; Mikell, FL; Moses, HW; Dove, JT; Batchelder, JE; Wellons, HA; Schneider, JA

Published Date

  • May 1, 1986

Published In

Volume / Issue

  • 111 / 5

Start / End Page

  • 840 - 844

PubMed ID

  • 2422911

Pubmed Central ID

  • 2422911

International Standard Serial Number (ISSN)

  • 0002-8703

Digital Object Identifier (DOI)

  • 10.1016/0002-8703(86)90631-9

Language

  • eng

Conference Location

  • United States