Restenosis and progression of coronary atherosclerosis after coronary angioplasty

AbstractThe relation between restenosis and progression or atherosclerosis in other coronary segments after angioplasty was studied in 98 consecutive patients with 110 coronary stenoses successfully treated with angioplasty. At early angiographic restudy (5 ± 2 months after angioplasty) 37 patients (38%) had restenosis (defined as a stenosis ≥ 50% of the luminal diameter or loss of ≥ 50% of the gain achieved by angioplasty); progression of atherosclerosis was observed in 4 patients with and 7 without restenosis (13 versus 11%, p = NS). Ninety of the 98 patients underwent a late angiographic restudy a mean of 34 ± 11 months after angioplasty. Late restenosis was found in one patient. Progression of coronary artery disease (defined as a ≥ 20% decrease in the diametor of a vessel initially narrowed by ≥ 50% or a ≥ 30% decrease when the initial stenosis was < 50%) was examined in relation to restenosis in 85 of the 90 patients. It occurred in 9 of 27 patients with and 22 of 58 patients without restenosis (33 versus 38%, p = NS).Restenosis developed more rapidly than did progression of disease. Diameter stenosis increased from 35 ± 8 to 73 ± 11% at the early restudy in lesions with restenosis; in lesions with disease progression it increased from 9 ± 18 to 20 ± 28% (p < 0.001) at the early restudy to 53 ± 21% (p < 0.001) at the late restudy. The incidence of progression of atherosclerosis was similar in dilated (16 of 94, 17%) and nondilated (25 of 176, 14%) arteries.These results suggest that restenosis and progression of atherosclerosis are independent phenomena and that the instrumentation associated with coronary angioplasty does not induce new lesions