[Percutaneous transluminal coronary angioplasty in ischemic heart disease]

Percutaneous transluminal coronary angioplasty (PTCA) is a transarterial catheterization technique for dilatation of coronary artery stenoses. Together with coronary artery bypass grafting (CABG) the method forms the basis for the invasive revascularization, both in the case of stable and unstable angina pectoris as well as an acute myocardial infarction (AMI), where thrombolytic therapy is contraindicated. The main indications are primarily patients with few and/or short coronary artery stenoses, whereas CABG is primarily performed in other situations and always in case of left main coronary stenoses. The primary success rate is 85-95% with clinical recurrence and cardiac events in 15-30% of patients with one-vessel disease and 25-50% with multi-vessel disease. Early recurrence is mainly due to restenosis, while late (> 8 months) is mostly caused by new-developed stenoses. The complications are few; acute occlusion at the site of dilatation occurs in 5-10%, leading to acute CABG in approximately 3% and non-fatal AMI in 2%. Mortality is less than 1%. Taking differences in the patient populations related to indications into account, the results of PTCA equal those of CABG as regards recurrence of anginal pain, AMI and mortality and are superior to antianginal medical treatment.