Coronary balloon angioplasty: a technique that is here to stay.

In this article, developments in the technique of percutaneous transluminal coronary angioplasty (PTCA) since its introduction in 1977 as well as current trends and likely future directions of the technique are outlined. Over the last 6 or 7 years, there has been a dramatic widening of the applications PTCA to include patients with complex anatomic lesions and adverse clinical features. Despite the large percentage of such difficult cases currently presenting for PTCA, an initial success rate in excess of 90% is achieved. Increased operator experience and continuing refinements in angioplasty technology are important factors in this continuing success of PTCA. Early restenosis remains the major drawback of the technique; this complication is usually treated by repeat PTCA. Available information indicates that the long-term outcome of patients after successful PTCA is excellent, with a low incidence of late restenosis and progression of disease. The relative efficacy of PTCA and coronary bypass surgery in patients with multivessel disease is, at present, uncertain.