[Transluminal coronary angioplasty: is a learning curve necessary?]

Transluminal coronary angioplasty is a complex technique, and a lesser percentage of success, or "learning curve", is reported in the initial experience of several investigators. Is reported here an initial series of 20 consecutive cases treated by coronary angioplasty for single vessel coronary disease with favourable results. After a meticulous medical treatment, coronary angioplasty was performed in the 20 cases with a "steerable" catheter and guide system and step-wise pressure inflations. In only 1 case (5%), with highly unstable clinical conditions and "unfavourable anatomy", the technique was followed by emergency aorto-coronary bypass and myocardial infarction. In 19 cases (95%) clinical and angiographic success was obtained, with a significant reduction of the mean measured coronary artery stenosis from 84.8 +/- 10.5% to a post-dilatation value of 15.6 +/- 10.5% (p less than 0.001). Coronary artery occlusion due to spasm or thrombosis or coronary dissection were never observed. This favourable series demonstrates that nowadays with the improved technology and with a scrupulous pharmacological protocol transluminal coronary angioplasty can be performed with a low incidence of complications and excellent results, further assessing its high potential in the treatment of ischemic coronary artery disease.