Late symptom recurrence after successful coronary angioplasty: angiographic outcome

Abstract

Objectives: To determine the angiographic appearance of the dilated coronary artery and the cause of symptoms in patients who presented with a return of chest pain more than 1 year after successful percutaneous transluminal coronary angioplasty (PTCA). Design: Retrospective analysis of coronary angiograms and review of case histories. Patients and methods: 112 patients who underwent repeat coronary arteriography for investigation of chest pain 13–105 (median, 30) months after successful coronary angioplasty were studied. All patients were free of symptoms for at least 12 months after the initial angioplasty. Results: A return of chest pain was attributed to restenosis in 12 patients (11%), to a new lesion or worsening of pre-existing coronary lesion in 56 patients (50%), and to both restenosis and stenosis in non-dilated coronary segments in 10 patients (9%). There was no restenosis in 112 of the 134 dilated lesions (84%). In 34 patients (30%), there was no significant stenosis in either dilated or non-dilated coronary segments. Conclusions: In patients undergoing coronary angiography for the investigation of recurrent chest pain more than 1 year after successful coronary angioplasty, the majority of dilated coronary segments had a good angiographic appearance. Late onset angina following PTCA is usually due to new coronary lesions or worsening of pre-existing mild stenosis.