[Coronary angioplasty in Italy: why the delay?]

Percutaneous transluminal coronary angioplasty is a new-surgical therapy for the treatment of obstructive coronary artery disease. It has rapidly assumed a definitive role. Indeed, in the US alone more than 170,000 procedures were carried out in 1987. This form of treatment was introduced into Italy in 1980 but it has failed to achieve the popularity that it enjoys in other European countries. Perhaps the reason for this is the inadequate advancement of coronary angiography. The number of coronary artery disease patients studied in Italy is still quite low. Thus, a solid basis is necessary if we are to establish a cardiological intervention routine. It is also interesting to note that even though Italy has a similar number of percutaneous coronary angioplasty centres to other countries, the number of procedures performed here is lower. In order to try and understand the reasons for this, we drew up a questionnaire based on the difficulties encountered. A total of 21 centres answered. During 1988, a total of 1,944 angioplasties were performed in these centres. The reasons given for this low number were as follows: difficulties associated with cardiological institutions; shortage of catheterization laboratories and of experienced personnel; problems associated with the hospitalization of patients; lack of continuity in surgical back-up; bed shortage in the intensive care units. Given the above mentioned situation, the solution must be sought at a central level in order to have an effectively co-ordinated approach which can give positive results.