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Abstract
Abrupt vessel closure is one of the worst events that can occur during PTCA.. It can lead to major complications like death, myocardial infarction and emergency coronary artery bypass graft. Abrupt closure incidence did not decrease over years inspite of improvement of the technology of PTCA and operator experience and this was assigned to broad expansion of the indications ofPTCA.
Objectives:
The aim of this work was to study the incidence of abrupt closure, define the different predictors of its occurrence and to highlight the modalities of its
Methods:
Fourty three patients (group A) who developed abrupt closure in the period between May 1997 and June 1999 in our Laboratory were included in our study. Fifty five patients with successful PTCA (group B) done in the same period were randomly chosen and included in the study for comparison. The total number of PTCA done during this period was 994 patients. The Patients underwent full clinical examination, echocardiography and exercise stress test before performing PTCA. Coronary angiography was performed to evaluate the type, site, length and severity of the target lesion. Computer analysis was used to accurately measure the length and severity of
the lesion. PTCA was done following the conventional techniques. The occurrence of abrupt closure. its mechanism, Procedural Predictors, sequalae and management were studied in detail for each patient. Clinical, angiographic and procedural predictors for abrupt closure were determined for every patient using mono variate and multivariate statistical analysis. Individual lesion scoring was calculated for each patient and the relationship between lesion score and percent prediction of abrupt closure was determined