[PTCA or alternative techniques? Balloon angioplasty remains dominant]

The use of second generation devices like excimer laser, rotablator, directional atherectomy, and stents is increasing. It is noteworthy that they are used in most cases in combination with "balloon" dilatation. The application of these more expensive techniques requires more experience and skills than mere balloon dilatation. Today, however, only three randomized trials were able to document some advantage of alternative devices in comparison to the traditional lumen enlargement with balloons (BENESTENT, STRESS, ERBAC). The following paper reflects our experience with balloon angioplasty in more than 15,000 patients, as well a critical review of new devices that were used in 19% of our patients in 1993.