The combination of diagnostic angiography and angioplasty as a single procedure is
becoming common practice in many institutions, but the feasibility and safety of this
strategy have not been reported. This report describes 2,069 patients who underwent
coronary angioplasty over a 3-year period at an institution where combined angiography
and angioplasty is the norm. All patients were prepared before angiography for potential
immediate angioplasty. In 1,719 patients, angioplasty was performed immediately after
the diagnostic angiogram, while separate procedures were performed in 350 patients.
Of those 350 patients, 254 were referred for angioplasty after diagnostic angiography
at other hospitals. One thousand one hundred ninety-seven patients were admitted electively
for treatment of stable angina pectoris, and 872 underwent procedures during hospitalization
for unstable angina or acute myocardial infarction. One thousand nine hundred seven
patients (92.2%) had successful angioplasties; in 130 patients (6.3%) the lesion could
not be dilated, but no complication occurred, and in 32 patients (1.5%) angioplasty
ended with a major complication (0.8% death, 1.0% Q-wave myocardial infarction, 0.5%
emergency coronary artery bypass surgery). There was no difference between the combined
and staged groups with regard to success, major and minor complication rates or in
length of hospitalization after angioplasty. We conclude that routine combined strategy
for angiography and angioplasty is feasible, safe, easier for the patient, and more
cost-effective than 2 separate procedures.