Percutaneous coronary angioplasty: technique, indications, and results

The simplicity, safety, and economic advantages of percutaneous transluminal coronary angioplasty (PTCA) over coronary bypass surgery have encouraged its wide use as an alternative revascularization procedure. Four major problem areas require solutions before the technique fulfills its potential. First, PTCA technology requires further development to enhance success rates in severe, old, calcified lesions and in chronic total occlusions. Second, acute vessel reclosure needs intensive study to determine how this important complication can be foreseen and effectively managed if not avoided entirely. Third, effective treatment strategies for patients with multivessel disease require definition. Finally, the problem of late lesion recurrence needs to be solved. Until these goals are achieved, the general practice of PTCA should be restricted to treatment of early-stage coronary artery disease, single-vessel, or discrete two- and three-vessel disease.