[Local development of coronary angioplasty]

From December 1980 to January 1989, over 1600 coronary angioplasty procedures were performed at the University Hospital of Geneva. The increase in interventions per year has been particularly marked since 1983 and coronary angioplasty procedures have since outnumbered coronary bypass operations, although the latter have been increasing too. The shortening of the waiting list for bypass surgery and the ageing of the surgical population can be attributed to coronary angioplasty. In the German-speaking part of Switzerland and in the country as a whole, coronary bypass surgery still dominates angioplasty in terms of numbers. Multivessel coronary angioplasty has decreased in importance in Geneva and accounts currently for about 10% of the procedures. The general growth of coronary angioplasty is therefore due to improvement in early detection of coronary artery disease, thus yielding good candidates for angioplasty, and to more frequent attempts at recanalization of chronic total coronary occlusions. This development is in keeping with that observed at the University Hospital of Lausanne but contrasts with those at the University Hospitals of Basel and Zurich. There, coronary angioplasty has gained importance only over the last 2 years, due to extension of indications to multivessel angioplasty. Primary success of the most recent 1500 interventions in Geneva was 85% with an incidence of major complications of 6% (infarction 3.5%, emergency surgery 2.0%, death 0.5%). In spite of technical improvements, there has been no persistent amelioration of results of coronary angioplasty over time. This may be explained by the fact that technically more intricate lesions (e.g., chronic total occlusions) have been tackled.(ABSTRACT TRUNCATED AT 250 WORDS)