[Coronary angioplasty today].
The rise of coronary angioplasty has been rapid in the last ten years. It is a method of myocardial revascularisation without thoracotomy or cardiopulmonary bypass and is curative in the absence of restenosis. Recent advances concern the development of the material and the pharmacological support which reduce the risk of coronary thrombosis during the procedure. The primary success rate now approaches 90%, that of emergency bypass surgery less than 5%. The use of autoperfusion catheters and the use of intra-aortic balloon pumping improve the safety of the procedure but surgical stand-by remains a necessity in cases of dilatation of proximal main coronary stenosis. Stable and unstable angina are the main indications of a technique particularly appropriate for elderly patients and the treatment of residual post-thrombolytic stenoses, post-radic stenosis or stenosis of a single functional coronary artery. Restenosis is observed in 30 to 40% of cases during the first six months after the dilatation. Its occurrence is not influenced by any of the drugs tested but it could be reduced by the insertion of an endocoronary stent. Abrasive endocoronary techniques and laser angioplasty are alternative methods of treating coronary stenoses inaccessible to conventional balloon angioplasty but they do not reduce the risk of restenosis.
Metzger
J P
JP
Clinique Cardiologique de l'hôpital Necker, Service du Pr Vacheron, Paris.
D015906:Angioplasty, Balloon, Coronary; D006801:Humans
Actualités de l'angioplastie coronaire.