Long-term follow-up of PTCA of the right coronary artery with shepherd's crook morphology.

The authors evaluated the long-term outcome of percutaneous transluminal coronary angioplasty (PTCA) of the right coronary artery in patients with shepherd's crook morphology (51 patients) compared to a control group (53 patients) matched for lesion location, date of procedure, age, and gender. The primary success rate was lower (86% v 98%; P = .03) in the shepherd's crook group than in the control group. At a mean follow-up of 29 months, there was one death in each group. The restenosis rate was 18% in the shepherd's crook group and 21% in the control group; repeat PTCA (14% v 15%) and bypass surgery (2% v 6%) rates were also similar in both groups. The data suggest that PTCA of right coronary arteries with shepherd's crook morphology has a significantly lower primary success rate but similar long-term outcome when compared to PTCA of right coronary arteries without this anatomic variation.