CORONARY INTERVENTION: WHERE ARE WE NOW?

Abstract

SUMMARYCoronary interventional techniques are used widely in the treatment of patients with coronary artery disease. With modern dilatation equipment the angiographic success rate of coronary balloon angioplasty may exceed 90%, but complications due to acute coronary occlusion may require emergency coronary artery bypass surgery (2 – 4%), or result in acute myocardial infarction (2 – 5%) or in‐hospital death (0 – 2%). In most patient groups the long‐term outcome of successful coronary angioplasty is good, but restenosis of a successfully dilated stenosis occurs in about 30% of cases, necessitating re‐intervention in a significant proportion of patients.Other interventional methods of treating coronary artery stenosis, including directional and rotational coronary atherectomy, endoluminal stenting, and laser angioplasty, have been used in preliminary clinical studies. The acute results of these techniques are encouraging but the restenosis rate remains high and the long‐term results are uncertain. The results of randomised clinical trials comparing coronary interventional techniques with alternative treatment methods are awaited.