[Transluminal coronary angioplasty. Ambitions and difficulties of the second generation]

Proposed in all functional forms of coronary heart disease and by gradually surmounting the obstacles of coronary arteriography, ballon catheter angioplasty, at the same time measures its limitations. These are recurring stenoses and failure of this procedure to cure chronic coronary occlusions, and they specifically characterize a method which, at the expense of unavoidable parietal lesions, does not eliminate the cause of the stenosis. It appears more desirable to remove atheromatous tissue by its extraction, vaporization or pulverization, to reinforce the wall of the coronary vessel, and these are the objectives of second-generation procedures. Development of angioscopy, lasers, atherotomies, and endoprostheses illustrates the vitality and the innovation present in invasive methods of cardiac therapeutic management. However, for the time being their clinical development of such procedures is incomplete and has not been sufficiently perfected. Future methods of angioplasty will be more satisfactory and have better control, but at present it is difficult to accurately predict the future aspects of such procedures.