Percutaneous transluminal coronary angioplasty for recurrence of symptoms following myocardial revascularisation

Twenty-five patients aged 40–75 years underwent percutaneous transluminal coronary angioplasty three months to nine years following coronary artery bypass graft surgery. Forty-four lesions (8 left anterior descending, 13 circumflex, 7 right internal mammary and 14 saphenous vein graft lesions) were attempted in 25 primary procedures with an overall angiographic success rate of 88.8 per cent. There were no deaths, myocardial infarctions or emergency revascularisation procedures. Two patients underwent elective coronary artery bypass grafting following inability to cross the total occlusions. Improvement in symptoms and exercise tolerance was seen in all the patients undergoing successful dilatations. On follow-up, three patients underwent repeat angioplasty after one month of initial dilatation. Percutaneous transluminal coronary angioplasty is a viable alternative in a selected group of symptomatic and/or stress-positive patients following coronary artery bypass graft surgery.