Percutaneous transluminal coronary angioplasty: the second decade

Over the last decade, percutaneous transluminal coronary angioplasty has become a major therapeutic technique of myocardial revascularization. Advances in catheter design and operator experience have made angioplasty a viable alternative for many patients with both single- and multivessel disease who would otherwise require bypass surgery. Acute closure and restenosis remain the 2 principal limitations of angioplasty. Means of controlling these problems, including intracoronary stenting and antiplatelet and thrombolytic agents, are now being studied. Furthermore, controlled prospective randomized trials are underway to assess the value of angioplasty compared with coronary bypass surgery in the treatment of multivessel disease. These trials will help to establish the limits of coronary angioplasty and its relative advantages in terms of therapeutic results and costs.