Clinical characteristics and angiographie follow-up of patients undergoing early or late repeat dilation for a first restenosis

AbstractObjective. The aim of this study was to analyze the angiographic rate of recurrent restenosis in patients who underwent repeat coronary angioplasty Tor a first restenosis within 3 months or > 3 months after the first procedure.Background. Several studies that have examined risk factors for restenosis after coronary angioplasty have suggested that a short interval between a first angioplasty and a repeat procedure is associated with an increased risk for a second restenosis.Methods. Between January 1981 and December 1990, 423 patients underwent a repeat coronary angioplasty procedure because restenosis had occurred at the site of a successful first angioplasty procedure. The clinical characteristics, immediate outcome and angiographie rate of recurrent restenosis were compared in patients who underwent repeat dilation within 3 months (early redilation group, n = 77) or > 3 months (late redilation group, n = 346) after the first procedure.Results. The incidence of unstable angina at the time of the repeat procedure was significantly signer in (be patienls who underwent early redilalion (42% vs. 8%, p = 0.0001). The procedural success rate (95%) and complication rate were similar in both groups. Follow-up autography was performed in 86% of patients with an initiaux successful procedure. The incidence of restenosis was significantly higher in the group that underwent early redilation (56% vs. 37%, p = 0.097) and was similar in patients in this group who presented with stable (55%) or unstable (57%) angina.Conclusions. Rapidly recurring coronary stenoses have an extremely high rate of resteaosis when again treated by coronary angioplasty, irrespective of the clinical presentation at the time of repeat dilation. The outcome in patients with early restenosis who have stable angina might be improved by delaying the repeat procedure