High incidence of acute coronary occlusions complicating percutaneous transluminal coronary angioplasty for angina pectoris

We report a disturbingly high early closure rate complicating 94 coronary angioplasties of native coronary arteries during a recent 5-year period. While the series is small, our findings are unusual in several respects. All patients were seen clinically and had their preangioplasty angiograms performed at the Veterans Administration Hospital by these investigators. They were then referred to 1 of 3 institutions where percutaneous transluminal coronary angioplasty (PTCA) was performed by high volume operators, the bulk of whose practice was among nonveterans (Figure 1). All the patients were men, relatively young and virtually all had proximal 1-vessel obstructions. Data analysis suggests that the high early closure rate correlates with lesion-specific angiographic risk factors.