[Transluminal balloon coronary angioplasty. Indications and results]

Thirteen years after its introduction transluminal balloon catheter angioplasty is a widely used technique. Owing to major technological advances and to the experience acquired by surgical teams, the primary success rate now reaches 90 p. 100. Hospital mortality has fallen down to 1 p. 100 and the need for emergency aorto-coronary bypass has been reduced to 4 p. 100 of the cases. However, despite repeated attempts at pharmacological or mechanical prevention, the restenosis rate remains around 30 p. 100. Coronary angioplasty is part of a wider strategy of myocardial reperfusion. Its indications are roughly the same as those of surgery. In patients with one-vessel coronary disease angioplasty is the first choice treatment, except for unprotected restenosis of the common trunk or very proximal lesions of the anterior interventricular artery. In multiple vessel disease the more complex the anatomical situation the more pronounced the left ventricular dysfunction and the greater the need for surgery. The acute phase of myocardial infarction is a legitimate indication for angioplasty, notably when thrombolytic agents are contraindicated or have failed when given intravenously, or in case of recurrence after an initially successful thrombolysis.