[Percutaneous transluminal coronary angioplasty: technical and anatomical considerations].

Four hundred and sixty-four coronary obstructive lesions of 321 patients were dilated by elective percutaneous transluminal coronary angioplasty (PTCA) from October 1981 to September 1984. The overall success rate was 72% (334 of 464 vessels). With respect to the sites of procedure, the success rate was 74% (192 of 260 lesions) in the left anterior descending artery (LAD), 74% (71 of 96 lesions) in the left circumflex artery (LCx), 66% (67 of 102 lesions) in the right coronary artery (RCA), 75% (three of four grafts) in bypass graft, and 50% (one of two lesions) in the left main trunk. The success rate related to the total number of diseased vessels was 79% (157 of 200 lesions) in one-vessel disease, 62% (110 of 177 lesions) in two-vessel disease, and 77% (63 of 82 lesions) in three-vessel disease. Considering the learning curve, the success rate was 52% to 56% for the initial 150 lesions, and 80% thereafter. Complications of elective PTCA were three deaths (0.9%), nine emergency A-C bypasses (2.8%), seven myocardial infarctions (2.2%), and three hemopericardia (0.9%). The success rate of PTCA was evaluated in regards to the morphology of the target lesion. There was no difference between narrowing more than 99% and narrowing less than 99%, though the success rate of diffuse stenosis was lower than that of the tubular or short lesion. The existence of previous myocardial infarction and ulcerating plaques did not relate to the success rate. Calcification or tortuosity significantly decreased the success rate. Length of anginal history did not relate to the success rate.(ABSTRACT TRUNCATED AT 250 WORDS)