[The best of 2001. Coronary angioplasty or post-interventional cardiology].
RAVEL, a major advance, represents the cardinal event of the year, if not the last ten years. For the first time zero-rate restenosis has been obtained by the placing of a stent coated with a drug with cytostatic properties. This trial puts the first steps of focal chemotherapy delivered by an endoprosthesis into a clinical form. This spectacular result begs to be confirmed in the long term, as well as in the numerous angiographic forms of stenosis currently indicating the placing of a stent. Such a result in the preventive treatment of restenosis of course casts a shadow on the curative intrastent treatment of restenosis, and especially on intra-coronary radiation. In the areas of acute coronary syndromes, and more particularly of myocardial infarction, the trials of pharmacological interventions have multiplied, bringing scattered information which everyone will find of relevance, and which by the wide choice that they suggest, give the prescriber a real degree of freedom. CAPTIM reveals that the clinical results of pre-hospital lysis followed by angioplasty (usually pre-planned) are identical to those of a primary angioplasty. This is good news for the numerous patients who are victims of an MI far from a centre equipped with interventional facilities. These studies, which do not summarize all the latest interventional work, testify to the evolution of the discipline which, currently controlling the area surrounding angiography of stenosis, is directed towards the focal and systemic pharmacological approach to the lesion.
Puel
J
J
Service de cardiologie, 1, avenue du Pr Jean-Poulhès, CHU Rangueil, 31043 Toulouse.
D017130:Angioplasty; D003327:Coronary Disease / Q000601:surgery*; D023903:Coronary Restenosis / Q000601:surgery; D006801:Humans; D013577:Syndrome