Focal angioplasty: theory and clinical application

Percutaneous transluminal coronary angioplasty (PTCA) has been performed with 20 mm long uni-diameter balloons for over 17 years with excellent results. It has now become possible to combine both compliant and non-compliant balloon material on a single device, allowing the interventionalist to direct the force of dilation to the lesion focally. This concept has been termed "focal angioplasty." This article reviews the concept of focal angioplasty, including the physics of balloon dilation, and describes current clinical applications for focal angioplasty. We discuss use of the focal angioplasty technique for PTCA and stenting and review the results of several ongoing clinical trials. While the acute results using focal angioplasty have been promising, long-term benefits have not been fully studied and will require completion of ongoing trials.