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Percutaneous transluminal coronary angioplasty: an expanding role in complex coronary artery disease.

Since its inception in 1977, percutaneous transluminal coronary angioplasty (PTCA) has played an increasing role in the treatment of complex single and multivessel coronary artery disease. Many patients, previously treatable only by coronary artery bypass grafting, are now successfully treated with PTCA in the cardiac catheterization laboratory. Two important limitations to the procedure, acute closure and restenosis of the dilated vessels, persist. However, studies with lasers, intracoronary stents, perfusion catheters, thrombolysis, and antiplatelet drugs are ongoing in an attempt to minimize these complications. In addition, studies are now ongoing comparing PTCA with bypass grafting to further define the role of each in coronary disease.