December 4, 2000
angioplasties remain successful
By Holly Korschun
In 1980, Emory Hospital became a pioneer of coronary angioplastythe less-invasive alternative to coronary bypass surgery in which catheters are used to improve blood flow to the heart.
Twenty years and 34,508 coronary angioplasties later, the success rate
of angioplasty at Emory has progressively increased, despite an older
and sicker patient population with more complex coronary problems.
John Douglas, director of coronary intervention at the hospital and one
of the most experienced interventional cardiologists in the world, presented
data from Emorys 20-year experience with angioplasty at the 73rd
meeting of the American Heart Associa-tion in New Orleans,
In our experience from 1980 through 1999, the success rate of angioplasty
has progressively increased, while the risk of needing bypass surgery
or of a heart attack complicating the procedure has decreased, Douglas
said. We also have observed a decrease in the length of time patients
must stay in the hospital which, along with reduced complications, has
a major impact on cost.
These successes have been realized despite an increasingly difficult
Over time, Douglas pointed out, the patient population needing angioplasties
has become generally older, more patients have had prior heart attacks
or have impaired heart function, and more patients have long-segment narrowing
of the arteries. In addition, 26 percent of patients needing coronary
angioplasty also have diabetes.
Since he began performing coronary angioplasty in 1980, Douglas, a professor
of medicine in the School of Medicine, has earned international recognition
for his expertise in the field he helped launch and has served on the
American College of Cardiology committee that established recommendations
for the development and maintenance of competency in coronary interventional
Douglas research has focused on improving the results of angioplasty
by using stents, new antithrombotic agents and intracoronary radiation,
and by developing methods to protect the myocardium (thickest part of
the heart wall) from tiny blood clots.
The Andreas Gruentzig Cardiovascular Center at Emory Hospital was established
in 1985 following the untimely death of Gruentzig, the first director
of Emorys interventional cardiology program.
Since its creation, the center has fostered numerous innovations, including
the first coronary stent to be placed in a human in this country. The
center also conducted the largest single-center study to compare angioplasty
and coronary bypass surgery and performed the first studies of the use
of beta radiation to prevent restenosis (renarrowing) after angioplasty.
We always have ongoing clinical trials to investigate new strategies
to improve patient outcomes, Douglas said. The goal is to
make coronary intervention safer and more durable. This retrospective
of our 20-year experience shows we are doing just that.