[15 years of coronary angioplasty: focus on the different techniques]

The growth of transcutaneous coronary angioplasty in the 1980s and early 1990s was particularly rapid, as about 42,000 procedures were performed in France in 1994. This treatment for coronary atherosclerosis now constitutes a valid alternative to surgical or medical treatment. New treatment modalities for coronary atherosclerosis have been added to the original balloon technique. Two types of coronary angioplasty can now be performed depending either by flattening and crushing the atheroma against the arterial wall (balloon, stent) or by destroying and fragmenting it (Rotablator, Laser, directional atherectomy). Among these new instruments, vascular stents have reduced the incidence of restenosis and have improved the safety of interventional cardiology, while others, such as Rotablator and Laser, allow the treatment of lesions inaccessible to the balloon. Directional atherectomy, by allowing specific excision, will occupy an important place in future developments of interventional cardiology, which is still a relatively young specialty.