Percutaneous transluminal coronary angioplasty: a surgeon's perspective

Percutaneous transluminal coronary angioplasty is a valuable adjunct in the treatment of various groups of patients with symptomatic coronary artery disease. In the authors' opinion, it is most valuable in patients with single-vessel disease of the right, circumflex, or distal left anterior descending coronary arteries. We also have found PTCA to be extremely helpful in managing patients with very complex coronary anatomy in whom surgery has not been completely successful or is not a reasonable option. Patients with triple-vessel disease or proximal left anterior descending lesions are treated best surgically. The value of many recent advances in PTCA techniques and long-term results (over 10 years), as well as the results of randomized studies, should help to clarify the situations in which PTCA and coronary bypass surgery are complementary, and those in which they are competitive.