Coronary artery aneurysm formation following percutaneous transluminal coronary angioplasty: Treatment of associated restenosis with repeat percutaneous transluminal coronary angioplasty

Gary D Walford, M. G. Midei, Thomas R Aversano, S. O. Gottlieb, P. H. Chew, Jeffrey A Brinker

Research output: Contribution to journalArticle

Abstract

Restenosis following coronary angioplasty can usually be treated effectively and safely by repeated angioplasty. However, the presence of a complex lesion morphology may bias the clinician away from angioplasty toward either recommending bypass surgery or continuing medical therapy alone in spite of recurrence of the symptoms which were sufficient indication for the initial angioplasty. One type of complex morphology at the site of the restenosis is due to the presence of a total, eccentric aneurysmal dilatation similar in appearance to a saccular aneurysm. In two previously reported cases in the literature both were referred to bypass surgery. We report eight additional cases including the use of repeat successful angioplasty in six of the cases in spite of the potential problems posed by the complexity of the restenosed lesion. In addition, this case review suggests that this type of complex lesion morphology with restenosis may be more common when the initial angioplasty was associated with deep arterial injury, as in patients whose initial angioplasty was done in an infarct-related vessel or was associated with evidence of a large dissection.

Original languageEnglish (US)
Pages (from-to)77-83
Number of pages7
JournalCatheterization and Cardiovascular Diagnosis
Volume20
Issue number2
DOIs
StatePublished - 1990

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Coronary Aneurysm
Coronary Balloon Angioplasty
Angioplasty
Coronary Vessels
Therapeutics
Coronary Restenosis
Aneurysm
Dissection
Dilatation
Recurrence
Wounds and Injuries

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Coronary artery aneurysm formation following percutaneous transluminal coronary angioplasty: Treatment of associated restenosis with repeat percutaneous transluminal coronary angioplasty",
abstract = "Restenosis following coronary angioplasty can usually be treated effectively and safely by repeated angioplasty. However, the presence of a complex lesion morphology may bias the clinician away from angioplasty toward either recommending bypass surgery or continuing medical therapy alone in spite of recurrence of the symptoms which were sufficient indication for the initial angioplasty. One type of complex morphology at the site of the restenosis is due to the presence of a total, eccentric aneurysmal dilatation similar in appearance to a saccular aneurysm. In two previously reported cases in the literature both were referred to bypass surgery. We report eight additional cases including the use of repeat successful angioplasty in six of the cases in spite of the potential problems posed by the complexity of the restenosed lesion. In addition, this case review suggests that this type of complex lesion morphology with restenosis may be more common when the initial angioplasty was associated with deep arterial injury, as in patients whose initial angioplasty was done in an infarct-related vessel or was associated with evidence of a large dissection.",
author = "Walford, {Gary D} and Midei, {M. G.} and Aversano, {Thomas R} and Gottlieb, {S. O.} and Chew, {P. H.} and Brinker, {Jeffrey A}",
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T1 - Coronary artery aneurysm formation following percutaneous transluminal coronary angioplasty

T2 - Treatment of associated restenosis with repeat percutaneous transluminal coronary angioplasty

AU - Walford, Gary D

AU - Midei, M. G.

AU - Aversano, Thomas R

AU - Gottlieb, S. O.

AU - Chew, P. H.

AU - Brinker, Jeffrey A

PY - 1990

Y1 - 1990

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AB - Restenosis following coronary angioplasty can usually be treated effectively and safely by repeated angioplasty. However, the presence of a complex lesion morphology may bias the clinician away from angioplasty toward either recommending bypass surgery or continuing medical therapy alone in spite of recurrence of the symptoms which were sufficient indication for the initial angioplasty. One type of complex morphology at the site of the restenosis is due to the presence of a total, eccentric aneurysmal dilatation similar in appearance to a saccular aneurysm. In two previously reported cases in the literature both were referred to bypass surgery. We report eight additional cases including the use of repeat successful angioplasty in six of the cases in spite of the potential problems posed by the complexity of the restenosed lesion. In addition, this case review suggests that this type of complex lesion morphology with restenosis may be more common when the initial angioplasty was associated with deep arterial injury, as in patients whose initial angioplasty was done in an infarct-related vessel or was associated with evidence of a large dissection.

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