Repeat coronary angioplasty as the treatment of choice for restenosis

A prospective study was performed to detemine whether multiple repeat coronary angioplasty can achieve final lesion patency after restenosis. Between 1983 and 1992, 1455 lesions (excluding acute myocardial infarction or total occlusion) were successfully dilated for the first time. Only 941 (68%) of the 1385 lesions followed up showed improved coronary flow (≤70% stenosis) after the first procedure. However, 1248 (93%) of 1345 lesions showed improved coronary flow after angioplasty had been repeated as many as three times, and 1268 (94%) of 1345 did so after as many as six procedures. Only 23 (1.6%) lesions required four or more procedures, and 20 of them showed final patency. These findings indicate that repeat angioplasty can be used as a reasonable treatment strategy for restenosis.