Advances in percutaneous coronary intervention.

Initially developed more than 30 years ago as simple balloon-based dilatation for focal coronary stenoses, the introduction of the coronary stent allowed percutaneous coronary intervention (PCI) to be applied to most patients with coronary artery disease. PCI improves quality of life by relieving angina in patients with stable coronary artery disease and can be life saving in patients with extensive ischemia and acute coronary syndromes. The safety of the PCI procedure has been enhanced significantly by the appropriate application of adjunctive pharmacotherapy, most importantly antithrombotic and antiplatelet agents. The advent of drug-eluting stents has significantly prolonged the durability of PCI. The safety and efficacy of PCI continue to evolve with the development of next-generation stents and safer and improved pharmacologic agents. An extensive evidence base of randomized clinical trials has established PCI as an important strategy with a pivotal role in the management of patients with coronary artery disease.