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  • Title: [Rate of success and restenosis of PTCA in patients over 75 years of age].
    Author: Reynen K, Kunkel B, Gansser R, Bachmann K.
    Journal: Z Kardiol; 1992 Mar; 81(3):157-63. PubMed ID: 1585713.
    Abstract:
    In 82 patients (pts), ages 75-90 years (52 m, 30 f; mean age 77 +/- 3 years) with mainly unstable angina (59 pts) or acute myocardial infarction (7 pts) a PTCA or recanalization was attempted. Successful PTCA was achieved in 57 of 69 pts (83%); occlusions could be reopened in all six pts with myocardial infarction and totally occluded infarct related artery, and in three of seven pts with stable or unstable angina pectoris. The primary success rate of PTCA alone in pts with unstable angina was 81%, and improved to 92% in pts with stable angina. Sixteen procedures were multiple vessel and six were multiple lesion PTCA, so that the lesion-related success rate of PTCA was higher (87%). One patient died in connection with the procedure (procedure related-mortality 1.2%), two pts underwent myocardial infarction (2.4%), one patient emergency bypass grafting (1.2%). The in-hospital mortality was 4.9% and concerned exclusively patients with unstable angina and unsuccessful procedure. Local complications at the puncture site occurred in two patients. The angiographic restenosis rate of PTCA was 58% (44% in patients with stable and 63% in patients with unstable angina pectoris). Seventeen patients with 19 restenoses had successful repeat PTCA; reintervention failed in two patients. We conclude that PTCA can be performed in patients of old age with a resulting comparable primary success rate as in younger patients. Complications seem to be more frequent. The restenosis rate is higher, but with regard to stable and unstable angina, not significantly so. The prognosis in patients with unstable angina and unsuccessful procedure is apparently unfavorable.
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