Balloon angioplasty in acute and chronic coronary artery disease.
Percutaneous transluminal coronary angioplasty has grown exponentially since its introduction. Currently, selection criteria include single-vessel and multivessel disease, stable and unstable angina, and acute infarction. The outcome depends on specific patient and angiographic characteristics. In ideal lesions, success rates should be greater than 90%, with low morbidity and mortality. With more severe and diffuse multivessel disease, success rates are lower and complication rates are higher. In these cases, percutaneous transluminal coronary angioplasty still offers a reasonable option, provided complete revascularization can be achieved or the angina-producing lesion dilated. Numerous issues remain unresolved, including (1) the role of percutaneous transluminal coronary angioplasty vs coronary surgery (currently being tested), (2) restenosis, which occurs in approximately 30% of treated lesions, and (3) organizational adjustments such as training and certification to maintain high standards of care.
Holmes
D R
DR
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minn 55905.
Vlietstra
R E
RE
D000789:Angina, Unstable / Q000628:therapy; D000800:Angioplasty, Balloon / Q000009:adverse effects; D002908:Chronic Disease; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000628:therapy*; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D009203:Myocardial Infarction / Q000628:therapy; D012306:Risk
D005343:Fibrinolytic Agents