Zeitler E, Feng G, Oldendorf M, Richter E I, Ritter W, Seyferth W
Radiologisches Zentrum des Städtischen Klinikums Nürnberg, Abteilung Diagnostik.
Herz. 1989 Feb;14(1):22-8.
Percutaneous transluminal angioplasty (PTA) can be subdivided into three epochs: 1. from its inception by Dotter and Judkins up to the first coronary artery stenosis dilatation with the Grüntzig balloon catheter system; 2. from the introduction of coronary stenosis dilatation by Grüntzig up to its unequivocal acceptance; 3. the period of influence of low-risk coronary dilatation on peripheral angioplasty and the search for techniques to compliment or obviate the need for balloon dilatation. The Grüntzig double-lumen balloon catheter system contributed to the lower rate of complications and higher success rate. The clinical acceptance appeared greater for the coronary arteries since, in contrast to the peripheral vascular system, the indication for treatment is established by the physician performing the dilatation. PTA implies percutaneous puncture of a vessel with Seldinger technique and introduction of devices such as guidewires, Dotter or Grüntzig catheters among others, catheters with fiberglass for laser conduction and instruments for fractionating, drilling and cutting. The goal of PTA is to completely or partially eliminate, without surgery, intraluminal vascular narrowing in the presence of peripheral arterial disease in stage II, III or IV. Prerequisite to the use of PTA are: 1. adequate fluoroscopic and angiographic facilities; 2. adequate instrumentation; 3. experience with at least 200 procedures; 4. knowledge of the pathophysiology and adjunctive treatment; 5. knowledge of the treatment of complications; 6. cooperation with a vascular surgery service. A number of factors may influence the results of treatment. Adjunctive medical treatment: the use of platelet aggregation inhibitors and heparin influences the rate of early rethrombosis.(ABSTRACT TRUNCATED AT 250 WORDS)