Transluminal coronary angioplasty--state of the art 1984.

Since its introduction in 1977 by Grüntzig, percutaneous transluminal coronary angioplasty (PTCA) has been increasingly applied to the treatment of coronary artery disease manifested by symptomatic ischemia. Initially only recommended for proximal short stenoses of one major coronary artery, the indication for PTCA has gradually been enlarged. Today even distally situated coronary stenoses in more than one vessel can be dilated successfully by using a steerable system. In experienced hands, an immediate improvement can be achieved in about 90% of the patients. In the realm of cost and morbidity PTCA offers obvious advantages over bypass surgery. However, indications for PTCA are more restricted than those for bypass surgery, specially in multi-vessel disease where the application of PTCA is still controversial. Moreover, long-term results are less favourable after PTCA since 25-30% of the patients show a recurrence within 6 to 12 months. Although PTCA will not replace coronary bypass surgery, it is already established as an alternative and complementary method for coronary revascularization.