Percutaneous transluminal coronary angioplasty: analysis of unsuccessful procedures as a guide toward improved results.

Technical success in percutaneous transluminal coronary angioplasty (PTCA) is a function of patient selection, operator experience, and the capabilities of the angioplasty equipment employed. When unsuccessful PTCA occurs, it is the result of one of several factors: (1) a failure to cross the stenosis; (2) a failure to dilate the stenosis; (3) an ischemic complication; or (4) a late recurrence of the anginal syndrome. In this paper, we discuss the relative frequency of these types of failure, and the ways in which improvements in technique and/or equipment may be employed to improve the chance of a successful procedure.