The influence of the presence of collaterals on restenoses after PTCA

Abstract

To assess the influence of collaterals on the long‐term follow‐up after successful percutaneous transluminal coronary arteriography (PTCA), 120 consecutive patients were studied. Of these, 104 (87%) had an adequate reangiogram and were included. At the time of PTCA the collaterals were estimated by a scoring system. In addtion, the coronary wedge pressure was measured in 49 patients six months after PTCA, a follow‐up angiogram was performed, and the patients were split up into a group with restenoses (stenosis >50%), 34 patients (32.7%); and a group without restenoses (stenosis <50%), 70 patients (67.3%). A total of 35 patients (30.7%) had collaterals. A comparison between both groups showed no significant differences in clinical parameters (age, angina duration, vessel involvement, lipids, blood sugar, and blood pressure), and stenoses‐related parameters (degree of stenoses, eccentricity, balloon size, inflation pressure, dissection, gradient after dilatation, and residual stenoses). Patients with collaterals had a significantly higher incidence of restenoses than those without collaterals (45.7% vs. 26.1%, p<0.05). Patients with wedge pressure of <45 mmHg (n = 30) had a significantly lower restenosis rate (23.3%) than patients with a coronary wedge pressure of >45 mmHg (n= 19) (restenosis rate 52.6%). It is concluded that the presence of collaterals indicates a high restenosis rate after PTCA within 6 months. Copyright © 1991 Wiley Periodicals, Inc.