Coronary angioplasty in Portugal

Coronary angioplasty began in Portugal in 1984 at the Santa Cruz Hospital and has developed progressively, being practiced in twelve hospitals since 1997. The number of patients with ischemic cardiopathy per annum that are submitted to this form of therapy has also increased. The increase is mainly in the past five years, from 684 procedures in 1993 to 3,005 in 1997. With regard to new devices, the use of intracoronary stents, which began in 1990 in Portugal is currently practised in all hospitals, 2,364 stents were implanted in 1997. This development of angioplasty has made it definitively established in Portugal, even in hospitals without cardiac surgery, as an alternative treatment to coronary surgery and medical treatment. In the absence of a national registry of interventional cardiology, which allows data to be gathered on the type of patients and the clinical situations in which angioplasty is used, it is not possible to ascertain whether medical treatment or surgical treatment have gained patients. Without evidence that surgery has decreased, it is presupposed that the increase in angioplasty is mainly the result of a greater number of diagnostic coronariographies. The current continued growth which has been observed, gives the impression that the development of the early diagnostic suspicion of coronary disease, easier access to coronariographies even in district hospitals and the improvement of technical conditions and manpower in central hospitals will sustain the increase in angioplasty in coming years. In becoming the solution to the problem of restenosis, angioplasty may undisputedly become the most promising therapeutic alternative in ischemic cardiopathy, in parallel with hypercholesterolemia control and other coronary risk factors.