Postthrombotic Therapy and Patient Follow-Up--The Role of Coronary Balloon Dilatation

After successful thrombolysis, a coronary stenosis of more than 50% of luminal diameter can be found in about 90% of all cases. These stenoses may impede the coronary flow, be the crystallisation point of another thrombus and be responsible for angina pectoris in the future. In 100 patients with successful thrombolysis angioplasty was performed immediately after clot lysis. The success rate was 74%, with no differences in concentric (60 cases) or eccentric stenoses (40 cases). The average diameter of the stenosis was reduced from 77·1 ± 11·0% to 34·4 ± 14·5% (improvement 42·7 ± 14·4±). After 6 mo in a group of 43 patients the mean stenosis rate had risen to 47·7 ± 23·2%. In 3 cases (3%) reocclusion of the vessel was induced by angioplasty. Although the combined method seems to be logical and without major complication rates, its merit has to be proven by randomised studies.