The limited impact of percutaneous coronary artery angioplasty on bypass surgery.
Although percutaneous transluminal coronary angioplasty has been used successfully now for 10 years, coronary bypass surgery volumes have not diminished greatly. This paper examines the anatomic limitations of percutaneous transluminal coronary angioplasty. Using complete revascularization criteria, angioplasty could be used in only 38% of patients undergoing coronary bypass surgery at the Cleveland Clinic in 1981. The principal anatomic reason for rejecting patients for percutaneous transluminal coronary angioplasty was chronic total occlusion in a vessel suitable for bypass surgery. Angioplasty could be used more frequently in one- and two-vessel bypass patients than in patients receiving more grafts. Percutaneous transluminal coronary angioplasty is currently limited more by its inability to more completely revascularize advanced coronary artery disease than it is from the technical aspects of crossing or dilating stenoses.
Hollman
J
J
Department of Cardiology, Cleveland Clinic Foundation, Ohio 44106.
D000800:Angioplasty, Balloon / Q000706:statistics & numerical data*; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data*; D003324:Coronary Artery Disease / Q000601:surgery; D003327:Coronary Disease / Q000601:surgery*; D006801:Humans; D009820:Ohio; D011379:Prognosis