Advertisement

Complications in Conventional and New Angioplasty Techniques

  • Martin Höher
  • V. Hombach
  • M. Kochs
  • W. Haerer
  • A. Schmidt
  • T. Eggeling
Conference paper

Abstract

The purpose of this article is to review the success rates and complication rates of balloon angioplasty, the conventional angioplasty technique, and newer techniques such as laser, atherectomy, and radiofrequency angioplasty. The main problem of such an analysis is the inhomogeneity of the so-called new interventional techniques in terms of both technical principles (thermal angioplasty by laser or radiofrequency, photoablation, mechanical atherectomy) and stage of development (Table 1). With some of the new techniques such as the Simpson atherectomy device [68, 76] clinical studies of about 500 patients are available, allowing a preliminary comparison with balloon angioplasty; other techniques such as radiofrequency angioplasty [34] have been clinically performed only in small patient groups.

Keywords

Balloon Dilatation Balloon Angioplasty Coronary Angioplasty Laser Angioplasty Primary Success Rate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Abela GS, Seeger JM, Barbieri E, Fronzini D, Fenech A, Pepine CJ, Conti CR (1986) Laser angioplasty with angioscopic guidance in humans. J Am Coll Cardiol 8: 184–192PubMedCrossRefGoogle Scholar
  2. 2.
    Ahn SS, Auth DC, Marcus DR, Moore WS (1988) Removl of focal atheromatous lesions by angioscopically guided high-speed rotary atherectomy. J Vasc Surg 7: 292–299PubMedGoogle Scholar
  3. 3.
    Alford WC, Stoney WS, Page HL, Burrus GR, Glassford DM, Petracek MR, Thomas CS (1982) Surgical procedures after percutaneous transluminal coronary angioplasty. South Med J 75: 1556–1558PubMedCrossRefGoogle Scholar
  4. 4.
    Aueron F, Gruentzig A (1984) Distal embolization of a coronary bypass graft atheroma during percutaneous transluminal coronary angioplasty. Am J. Cardiol 53: 953–954Google Scholar
  5. 5.
    Bauriedel G, Dartsch PC, Voisard R, Roth D, Simpson JB, Höfling B, Betz E (1989) Selective percutaneous biops of atheromatous plaque tissue for cell culture. Basic Res Cardiol 84: 326–331PubMedCrossRefGoogle Scholar
  6. 6.
    Buchwald A, Werner GS, Unterberg C, Voth E, Figulla HR, Wiegand V (1989) Excimer-LaserKoronarangioplastie hochgradiger Stenosen and chronischer Okklusionen. Z Kardiol 78: 714–718PubMedGoogle Scholar
  7. 7.
    Cairns JA, Collins R, Fuster V, Passamani ER (1989) Coronary thrombolysis. Chest 95: 735–875CrossRefGoogle Scholar
  8. 8.
    Chan MC, Lee G, Jing-Xuan G, Mao JU, Chen F, Yan W, Xie D, Rink DL, Argenal AJ, Mason DT (1989) Percutaneous coronary laser angioplasty using quick short bursts of laser thermal energy for chronic total occlusions. Am J Cardiol 64: 940–942PubMedCrossRefGoogle Scholar
  9. 9.
    Choy DSJ, Stertzer SH, Myler RK, Marco J, Fournial G (1984) Human coronary laser recanalization. Clin Cardiol 7: 377–381PubMedGoogle Scholar
  10. 10.
    Côté G, Stertzer SH, Mylr RK, Bonan R, Andrus WS, Roth L, Lane J, Dumont M, Maden M, Hidalgo BO (1989) Early clinical experience with percutaneous transluminal argon laser coronary angioplasty. J Am Coll Cardiol 13: 61A (abstr.)Google Scholar
  11. 11.
    Dartsch PC, Voisard R, Bauriedel G, Höfling B, Betz E (1990) Growth characteristics and cytosceletal organisation of cultered smooth muscle cells from primary and restenosed lesions Arteriosclerosis 10: 62–75PubMedCrossRefGoogle Scholar
  12. 12.
    Detre K, Holubkov R, Kelsey S, Cowley M, Kent K, Williams D, Myler R, Faxon D, Holmes Jr D, Bourassa M, Block P, Gosselin A, Bentivoglio L, Leatherman L, Dorros G, King III S, Galichia J, Al-Bassam M, Leon M, Robertson T, Passamani E (1988) Percutaneous transluminal coronary angioplasty in 1985–1986 and 1977–1981. The National Heart, Lung, and Blood Institute Registry. N Engl J Med 138: 265–270Google Scholar
  13. 13.
    Detre K, Holubkov R, Kelsey S, Bourassa M, Williams D, Holmes Jr D, Dorros G, Faxon D, Myler R, Kent K, Cowley M, Cannon R, Robertson T (1989) One-year follow-up results of the 1985–1986 National Heart, Lung, and Blood Institute’s Percutaneous transluminal coronary angioplasty registry. Circulation 80: 421–428Google Scholar
  14. 14.
    Dorros G, Lewin RF, Mathiak LM, Johnson WD, Brenowitz J, Schmahl T, Tector A (1988) Per-cutaneous transluminal coronary angioplasty in patients with two or more previous coronary artery bypass grafting operations. Am J Cardiol 61: 1243–1247PubMedCrossRefGoogle Scholar
  15. 15.
    Douglas JS Jr, Gruentzig AR, King SB III, Hollman J, Ischingr T, Meier B, Carver JM, Jones EL, Waller JL, Bone DK, Gyuton R (1983) Percutaneous transluminal coronary angioplasty in patients with prior coronary bypass surgery. J Am Coll Cardiol 2: 745–754PubMedCrossRefGoogle Scholar
  16. 16.
    Ellis SG, Roubin GS, King SB, Douglas JS, Shaw RE, Stertzer SH, Myler RK (1988) In-hospital cardiac mortality after acute closure after coronary angioplasty: Analysis of risk factors from 8,207 procedures. J Am Coll Cardiol 11: 211–216PubMedCrossRefGoogle Scholar
  17. 17.
    Ellis SG, O’Neill WW, Bates ER, Walton JA, Nabel EG, Werns SW, Topol EJ (1989) Implications for patient triage from survival and left ventricular functional recovery analyses in 500 patients treated with coronary angioplasty for acute myocardial infarction. J Am Coll Cardiol 13: 1251–1259PubMedCrossRefGoogle Scholar
  18. 18.
    Erbel R, Dietz U, Mixdorf U, Haude M, Rupprecht HJ, Auth D, Meyer J (1989) Koronare Hochfrquenz-Rotations-Arterektomie. Z Kardiol 78 (Suppl 1 ): 21 (abstr.)Google Scholar
  19. 19.
    Foschi AE, Zapala CA (1989) Direct argon laser irradiation of high-grade stenoses and total occlusions in native human coronary arteries and bypass grafts: Initial clinical experience. J Am Coli Cardiol 13: 60A (abstr.)CrossRefGoogle Scholar
  20. 20.
    Fourrier JL, Bertrand ME, Auth DC, Lablanche JM, Gommeaux A, Brunetaud JM (1989) Per-cutaneous coronary rotational angioplasty in Humans: Preliminary report. J Am Coll Cardiol 14: 1278–1282Google Scholar
  21. 21.
    Garrison BJ, Srinivasan R (1984) Microscopic model for the ablative photodecomposition of polymers by far ultraviolet radiation (193nm). Appl Phys Lett 44: 849–851CrossRefGoogle Scholar
  22. 22.
    Gaul G, Hollman J, Simpfendorfr C, Franco I (1989) Acute occlusion in multiple lesion coronary angioplasty: Frequency and management. J. Am Coll Cardiol 13: 283–288Google Scholar
  23. 23.
    Ginsburg R, Wexler L, Mitchell RS, Profitt D (1985) Percutaneous transluminal laser angioplasty for treatment of peripheral vascular disease: clinical experience with sixteen patientsGoogle Scholar
  24. 24.
    Ginsburg R, Teirstein PS, Warth DC, Haw N, Jenkins NS, McCowan LC (1989) Percutaneous transluminal coronary rotational atheroblation: Clinical experience in 40 patients. Circulation 80: I1584 (abstr.)Google Scholar
  25. 25.
    Grüntzig AR, Senning A, Siegenthaler WE (1970) Nonopertive dilation of coronary-artery stenosis: percutaneous transluminal coronary angioplasty. N Engl J Med 301: 61–68CrossRefGoogle Scholar
  26. 26.
    Grundfest WS, Litvack IF, Goldenberg T, Shermann T, Morgenstern L, Carroll R, Fishbein M, Forrester J, Margitan J, McDermid S (1985) Pulsed ultraviolet lasers and the potential for safe laser angioplasty. Am J Surg 150: 220–226PubMedCrossRefGoogle Scholar
  27. 27.
    Grundfest W, Litvack F, Hickey A, Adler L, Foran R, Lewin P, Segalowitz J, Hestrin L, Forrester J (1989) Radiofrequency thermal angioplasty for the treatment of peripheral vascular occlusiove disease: Preliminary results of a clinical trial. J Am Coll Cardiol 13: 14A (abstr.)Google Scholar
  28. 28.
    Hamad N, Pichard A, Lyle HRP, Lindsay J (1988) Results of percutaneous transluminal coronary angioplasty by multiple, relatively low frequency operators: 1986–1987 experience. Am J Cardiol 61: 1229–1231PubMedCrossRefGoogle Scholar
  29. 29.
    Hansen DD, Auth DC, Vrocko R, Ritchie JL (1988) Rotational atherectomy in atherosclerotic rabbit iliac arteries. Am Heart J 115: 160–165PubMedCrossRefGoogle Scholar
  30. 30.
    Harston WE, Tilley S, Rodeheffer R, Formann MB, Perry JM (1986) Safety and success of the beginning percutaneous transluminal coronary angioplasty program using the sterrable guidewire system. Am J Cardiol 57: 7K - 10KCrossRefGoogle Scholar
  31. 31.
    Higgins CB (1988) Coronary angiography: A decade of advances. Am J Cardiol 62: 7K - 10KPubMedCrossRefGoogle Scholar
  32. 32.
    Hollman J, Gruentzig AR, Douglas JS Jr, King SB, Ischinger T, Meier B (1983) Acute occlusion after percutaneous transluminal coronary angioplasty–a new approach. Circulation 68: 725–732PubMedCrossRefGoogle Scholar
  33. 33.
    Holmes DR, Holubkov R, Vlietstra RE, Kelsey SF, Reeder GS, Dorros G, Williams DO, Cowley MJ, Faxon DP, Kent KM, Bentivoglio LG, Detre K (1988) Comparison of complications during per-cutaneous transluminal coronary angioplasty from 1977 to 1981 and from 1985 to 1986: The National Heart, Lung, and Blood Institute Percutaneous Transluminal Coronary Angioplasty Registry. J. Am Coll Cardiol 12: 149–155Google Scholar
  34. 34.
    Hombach V, Höher M, Höpp HW, Kochs M, Eggeling T, Osypka P, Hilger HH (1988) Erste klinische Erfahrungen mit der Hochfrequenzangioplastie bei Patienten mit koronarer Herzkrankheit. Dtsch Med Wschr 113, 801–805PubMedCrossRefGoogle Scholar
  35. 35.
    Hombach V, Höher M, Kochs M, Wieshammer S, Haerer W, Eggeling T, Schmidt A, Höpp HW, Hilger HH (1989) Radiofrequency coronary angioplasty in patients with coronary artery disease–a new method for treatment of coronary artery stenoses. In: Höfling B, v Pölnitz A (eds): Interventional cardiology and angiology. Steinkopff Verlag, Darmstadt, 163–168Google Scholar
  36. 36.
    Isley CDJ, Ablett MD (1986) Percutaneous transluminal coronary angioplasty in multilesion disease: complete versus incomplete revascularization. Tex Heart Inst J 13: 371–376Google Scholar
  37. 37.
    Jacob AS, Pichard AD, Ohnmacht SD, Lindsay J (1986) Results of percutaneous transluminal coronary angioplasty by multiple relatively low frequency operators. Am J Cardiol 57: 713–716PubMedCrossRefGoogle Scholar
  38. 38.
    James TN (1965) Anatomy of the coronary arteries in health and disease. Circulation 32: 1020–1029PubMedGoogle Scholar
  39. 39.
    Kaltenbach M, Kober G, Scherer D, Vallbracht C (1985) Recurrence rate after successful coronary angioplasty. Eur Heart J 6: 276–281PubMedGoogle Scholar
  40. 40.
    Karsch KR, Haase KK, Mauser M, Ickrath O, Voelker W, Duda S, Seipel L (1989) Perkutane transluminale koronare Excimer-Laserangioplastie. Dtsch Med Wschr 114: 1183–1187PubMedCrossRefGoogle Scholar
  41. 41.
    Keogh B, Crea F, Bull T, Blackie S, Taylor KM (1988) An in vitro study to assess the risk of embolism following lasing human coronary atherosclerotic plaque with metal-capped optical fibers. Eur Heart J 9 (Suppl 1 ): 235 (abstr.)Google Scholar
  42. 42.
    Keogh B, Crea F, Pashazadeh M, Blackie RAS, Taylor KM (1988) Lasing in blood with metal-capped optical fibres: The potential hazard of distal thrombembolism. Eur Heart J 9 (Suppl 1 ): 235 (abstr.)Google Scholar
  43. 43.
    King SB (1988) Percutaneous transluminal coronary angioplasty: The second decade. Am J Cardiol 62: 2K - 6KPubMedCrossRefGoogle Scholar
  44. 44.
    Knudtson ML, Spindler BM, Traboulsi M, Spears JR (1989) Coronary laser balloon angioplasty in chronic total occlusion provides excellent short-term results. Circulation 80:íI-476 (abstr.)Google Scholar
  45. 45.
    Lee G, Ikeda RM, Kozina J, Mason DT (1981) Laser-dissolution of coronary atherosclerotic obstruction. Am Heart J 102: 1074–1075PubMedCrossRefGoogle Scholar
  46. 46.
    Linnemeier TJ, Cumberland DC, Rothbaum DA, Landin RJ, Ball MW (1989) Human percutaneous laser-assisted coronary angioplasty: Efforts to reduct spasm and thrombosis. J Am Coll Cardiol 13: 6IA (abstr.)Google Scholar
  47. 47.
    Litvack F, Grundfest WS, Goldenberg T (1988) Pulsed laser angioplasty: wavelength power and energy dependencies relevant to clinical applicationGoogle Scholar
  48. 48.
    Litvack F, Grundfest WS, Goldenberg T, Laudenslager J, Forrester JS (1989) Percutaneous excimer laser angioplasty of aortocoronary saphenous vein grafts. J Am Coll Cardiol 14: 803–808PubMedCrossRefGoogle Scholar
  49. 49.
    Margolis JR, Litvack F, Grundfest W, Eigler N, Goldenberg T, Laudenslager J, Tsoi D, Wong S, Segalowitz J, Hestrin L, Rothbaum D, Linnemeier T, Helfant R, Forrester J (1989) Excimer laser coronary angioplasty: Results of a multicenter study. Circulation 80: 11–477 (abstr.)Google Scholar
  50. 50.
    Meier B (1987) Coronary angioplasty. Grune & Stratton Inc., OrlandoGoogle Scholar
  51. 51.
    Meier B, King SB, Gruentzig AR, Douglas JS, Hollman J, Ischinger T, Galan K, Tankersley R (1984) Repeat coronary angioplasty. J. Am Coll Cardiol 4: 463–466PubMedCrossRefGoogle Scholar
  52. 52.
    Meier B, Gruentzig A, King S, Douglas J, Hollman J, Ischinger T, Galan K (1984) Higher balloon dilatation pressure in coronry angioplasty. Am Heart J 107: 619–62PubMedCrossRefGoogle Scholar
  53. 53.
    Myler RK, Topol EJ, Shaw RE, Stertzer SH, Clark DA, Fishman J, Murphy MC (1987) Multiple vessel coronary angioplasty: classification, results and patterns of restenosis in 494 consecutive patients. Cathet Cardiovasc Diagn 13: 1–15PubMedCrossRefGoogle Scholar
  54. 54.
    O’Keefe JH Jr, Rutherford BD, McConahay DR, Ligon RW, Johnson WL, Giogi LV, Crockett JE, McCallister BD, Conn RD, Gura GM, Good TH, Steinhaus DM, Bateman TM, Shimshak TM, Hartzler GO (1989) Early and late results of coronary angioplasty without antecedent therombolytic therapy for acute myocardial infarction. Am J Cardiol 64: 221–1230Google Scholar
  55. 55.
    O’Neill WW, Friedman HZ, Cragg D, Strzelecki MR, Gangadharan V, Levine AB, Ramos RG (1989) Initial clinical experience and early follow-up of patients undergoing mechanical rotary endarterectomy. Circulation 80: 11–584 (abstr.)Google Scholar
  56. 56.
    Oomen A, Tuntelder JR, Velema E, Verdaasdonk RM, Rienks R, Borst C (1988) Laser-heated metal probe recanalisation of aortic stenosis in the rabbit: embolisation and wall damage. Eur Heart J 9 (Suppl 1 ): 235 (abstr.)Google Scholar
  57. 57.
    Pinkerton C, Simpson J, Selmon M, Robertson G, Hinohara T, Hollman J, Balm D (1989) Per-cutaneous coronary atherectomy: Early experiences of multicenter trial. J Am Coll Cardiol 13: 108A (abstr.)Google Scholar
  58. 58.
    Reeder GS, Breshnahan JF, Holmes DR Jr, Mock MB, Orszulak TA, Smith HC, Vlietstra RE (1986) Angioplasty for aortocoronary bypass graft stenosis. Mayo Clin Proc 61: 14–19PubMedGoogle Scholar
  59. 59.
    Roubin GS, Douglas Jr JS, King III SB, Lin S, Hutchison N, Thomas RG, Gruentzig AR (1988) Influence of balloon size on initial success, acute complications, and restenosis after percutaneous transluminal coronary angioplasty. A prospective randomized study. Circulation 78: 557–565Google Scholar
  60. 60.
    Safian RD, Gelbfish JS, Erny RE, Schnitt S, Bairn DS (1989) Histologic findings of coronary atherectomy. Circulation 80:íI-583 (abstr.)Google Scholar
  61. 61.
    Sanborn TA, Faxon DP, Haudenschild CC, Ryan TJ (1985) Experimental angioplasty: Circumferential distribution of laser thermal energy with a laser probe. J. Am Coll Cardiol 5: 934–938Google Scholar
  62. 62.
    Sanborn TA, Haudenschild CC, Faxon DP, Garber GR, Ryan TJ (1987) Angiographic and histologic consequences of laser thermal angioplasty: Comparison with balloon angioplasty. Circulation 75: 281286Google Scholar
  63. 63.
    Sanborn TA, Cumberland DC (1989) Laserprobe. In: Isner JM, Clarke RH (eds): Cardiovascular laser therapy. Raven Press, New York. 149–162Google Scholar
  64. 64.
    Schmitz HJ, Von Essen R, Meyer J, Effert S (1984) The role of balloon size for acute and late angiographic results in coronary angiography. Circultion 70 (suppl II): II-295 (abstr.)Google Scholar
  65. 65.
    Schömig A, Brachmann J, Müller—Bühl U, Scheidt D, Wilhelm C, Kübler W (1989) Klinische Anwendung eines Argon-Laser-Systems bei peripheren and coronaren Arterienverschlüssen. Z Kardiol 78 (Suppl 1 ): 21 (abstr.)Google Scholar
  66. 66.
    Simoons ML, Arnold AE, Betriu A, de Bono DP, Col J, Dougherty FC, von Essen R, Lambertz H, Lubsen J, Meier B (1988) Thrombolysis with tissue plasminogen activator in acute myocardial infarction: no additional benefit from immediate percutaneous coronary angioplasty. Lancet: 197–202Google Scholar
  67. 67.
    Simpfendorfer C, Belardi J, Bellamy G, Galan K, Franco I, Hollman J (1987) Frequency, management, and follow-up of patients with acute coronary occlusion after percutaneous transluminal coronary angioplasty. Am J Cardiol 59: 267–259PubMedCrossRefGoogle Scholar
  68. 68.
    Simpson JB, Selmon MR, Robertson GC, Cipriano PR, Hayden WG, Johnson DE, Fogarty TJ (1988) Transluminal atherectomy for occlusive peripheral vascular disease. Am J Cardiol 61: 93G - 101GCrossRefGoogle Scholar
  69. 69.
    Simpson JB, Bairn DS, Robert EW, Harrison DC (1982) A new catheter system for coronary angioplasty. Am J Cardiol 49: 1216–1222PubMedCrossRefGoogle Scholar
  70. 70.
    Simpson JB, Robertson GC, Selmon MR, Sipperly E, Braden LJ, Hinohara T (1989) Restenosis following successful directional coronary atherectomy. Circulation 80: 11–582Google Scholar
  71. 71.
    Spears JR (1989) Sealing. In: Isner JM, Clarke RH (eds): Cardiovascular laser therapy. Raven Press, New York, 177–199Google Scholar
  72. 72.
    Spears JR, Dear WE, Safian RD, Sinclair IN, Plokker HWM, Aldridge H, Knudtson ML, Sigwart U, Rickards AF (1989) Laser balloon angioplasty: Angiographic results of a multicenter trial. Circulation 80: 11–476 (abstr.)Google Scholar
  73. 73.
    TIMI Study Group (1989) Comparison of invasive and conservative strategies after treatment with intravenous tissue plasminogen activator in acute myocardial infarction. New Engl J Med 320: 618–627CrossRefGoogle Scholar
  74. 74.
    Teirstein PS, Hoover CA, Ligon RW, Giorgi LV, Rutherford BD, McConahay DR, Johnson WL, Hartzler GO (1989) Repeat coronary angioplasty. Efficacy of a third angioplasty for a secon restenosis. J Am Coll Cardiol 13: 291–296PubMedCrossRefGoogle Scholar
  75. 75.
    Topol EJ, Califf RM, George BS, Kereiakes DH, Abbottsmith CW, Candela RJ, Lee KL, Pitt B, Stack RS, O’Neill WW (1987) A randomized trial of immediate versus delayed elective angioplasty after intravenous tissue plasminogen activator in acute myocardial infarction. N Engl J Med 317: 581–588PubMedCrossRefGoogle Scholar
  76. 76.
    Vlietstra RE, Abbotsmith CW, Douglas JS, Holtman JL, Muller D, Safian R, Selmon MR (1989) Complications with directional coronary atherectomy. Experience at eight centers. Circulation 80 (Suppl II), II-582 (abstr.)Google Scholar
  77. 77.
    Williams DO, Grüntzig AR, Kent KM, Detre KM, Kelsey SF, to T (1984) Efficacy of repeat percutaneous transluminal coronary angioplasty for coronary restenosis. Am J Cardiol 53: 32C - 35C.PubMedCrossRefGoogle Scholar

Copyright information

© Dr. Dietrich Steinkopff Verlag GmbH & Co. KG, Darmstadt 1991

Authors and Affiliations

  • Martin Höher
    • 1
    • 2
  • V. Hombach
    • 1
  • M. Kochs
    • 1
  • W. Haerer
    • 1
  • A. Schmidt
    • 1
  • T. Eggeling
    • 1
  1. 1.Department of Cardiology-Pneumonology-AngiologyUniversity of UlmGermany
  2. 2.Department of Cardiology-Pneumonology-AngiologyUniversity UlmUlmGermany

Personalised recommendations