[The primary outcome in transluminal coronary angioplasty: the recent experience of the Instituto Nacional de Cardiología (1991-1992)].

Percutaneous balloon coronary angioplasty had a slow start in Mexico, and until recently only a relatively small number of procedures have been performed. Since March 1991, the Instituto Nacional de Cardiología has state-of-the-art fluoroscopic imaging and easy access to a variety of balloon coronary angioplasty catheters and accessories. Under these conditions, an increasing number of PTCAs have been performed (221 procedures in an initial 15 month period). The primary results of PTCA in this patient population is presented as a reference source for results of PTCA in our population. Indication for PTCA was stable angina in 31%, unstable angina in 64% and AMI in 5%. Forty-two percent of the procedures were for multivessel PTCA, with a total of 355 lesions approached (1.6 segments per patient). There were 34% type A, 51% type B and 15% type C lesions. Mean percent stenosis was reduced from 81% to 29% (p < 0.001). There was a 94% success rate in type A lesions, 89% in type B and 77% in type C lesions. Six patients required urgent CABG (2.7%), thirteen had a myocardial infarction (5.9%) and mortality was 1.35% (including one patient with cardiogenic shock who had a noncomplicated failure and had a late in-hospital death). We conclude that with adequate support and equipment, angioplasty results compare favorably to those reported by more experienced groups in developed nations. Also, the necessary number of procedures for the maintenance of competence in PTCA can be done in our country.