Radiology, Vol 161, 681-683, Copyright © 1986 by Radiological Society of North America
Side branch occlusion complicating percutaneous transluminal coronary angioplasty
LM Boxt, MF Meyerovitz, RH Taus, P Ganz, PL Friedman and DC Levin
A frequent concern during angioplasty is the possibility of occluding
important side branches that originate in arterial stenoses subjected to
balloon dilatation. The effect of dilatation on 93 side branches (greater
than or equal to 1 mm in diameter) was evaluated in 86 patients undergoing
percutaneous transluminal coronary angioplasty (PTCA) in whom those
branches arose directly in dilated segments of the left anterior
descending, circumflex, or right coronary arteries. Seventy-six of the 93
side branches had minor (less than 50%) narrowing at their origin. Among
these side branches, nine (12%) were compromised by PTCA. Seventeen of the
93 side branches had greater than 50% ostial stenosis. Significantly more
of these side branches (seven of seventeen, or 41%) were compromised by
PTCA (P less than .01). Even when compromise does occur, it usually takes
the form of increased stenosis rather than total occlusion. The presence of
side branches originating in stenotic lesions is not a contraindication to
PTCA since serious compromise of such branches rarely results from this
procedure.
