793-1 Local, Low Pressure Heparin Delivery Following Angioplasty in Man: The Solution to Restenosls?

Of 38 patients (28 men, 58±10 years) treated by conventional balloon angioplasty followed by local heparin delivery (1660±656 IU at low pressure 110±48 mmHg during 30±7 min) through the DispatchTM (Scimed) 20 (12 men, 57±10 years). have undergone 6 month review. One 78 year old patient with aortic stenosis died in hospital 7 weeks after the procedure from acute heart failure following 2 transfusions for the exacerbation of ulcerative colitis. Of the 19 remaining patients clinical follow-up was available for all and control angiography was performed in 14 (74%). Of the 5 who declined, all asymptomatic, 3 had a negative MIBI scintigram and 2 refused further examination. Symptoms Five (26%) of the 19 patients were symptomatic (3 exertional and 2 atypical angina) and angiography showed 4 new lesions and 1 restenosis (diameter stenosis 60%) of the target lesion. Angiogram No aneurysmatic dilatation at the site of delivery was visualized. However 4 out of 14 (29%) lesions had a increase in MLD (range: 0.17–0,51 mm). Mean MLD measured by quantitative analysis (CAAS II) in matched projections (post-procedure vs 6 month follow-up) was 2.0±0.5 mm vs 1.73±0.4 mm representing a mean late loss of 0.27 mm. The incidence of restenosis, defined as a diameter stenosis at follow-up of >50% was 7%. None of patients required re-angioplasty of the treated segment. Conclusion Local, low pressure heparin delivery following balloon angioplasty may reduce incidence of restenosis and decrease the need for re-angioplasty.