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Review
. 2003 May 17;326(7398):1080-2.
doi: 10.1136/bmj.326.7398.1080.

ABC of interventional cardiology: percutaneous coronary intervention. I: history and development

Ever D Grech  1
Affiliations
Review

ABC of interventional cardiology: percutaneous coronary intervention. I: history and development

Ever D Grech. BMJ. .
No abstract available

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Figures

Figure 1
Figure 1
Major milestones in percutaneous coronary intervention
Figure 2
Figure 2
Modern balloon catheter: its low profile facilitates lesion crossing, the flexible shaft allows tracking down tortuous vessels, and the balloon can be inflated to high pressures without distortion or rupture
Figure 3
Figure 3
Micrographs showing arterial barotrauma caused by coronary angioplasty. Top left: coronary arterial dissection with large flap. Top right: deep fissuring within coronary artery wall atheroma. Bottom: fragmented plaque tissue (dark central calcific plaque surrounded by fibrin and platelet-rich thrombus), which may embolise in distal arterioles to cause infarction, and intramural and perivascular haemorrhage (bottom)
Figure 3
Figure 3
Micrographs showing arterial barotrauma caused by coronary angioplasty. Top left: coronary arterial dissection with large flap. Top right: deep fissuring within coronary artery wall atheroma. Bottom: fragmented plaque tissue (dark central calcific plaque surrounded by fibrin and platelet-rich thrombus), which may embolise in distal arterioles to cause infarction, and intramural and perivascular haemorrhage (bottom)
Figure 3
Figure 3
Micrographs showing arterial barotrauma caused by coronary angioplasty. Top left: coronary arterial dissection with large flap. Top right: deep fissuring within coronary artery wall atheroma. Bottom: fragmented plaque tissue (dark central calcific plaque surrounded by fibrin and platelet-rich thrombus), which may embolise in distal arterioles to cause infarction, and intramural and perivascular haemorrhage (bottom)
Figure 4
Figure 4
Tools for coronary atherectomy. Top: the Simpson atherocath has a cutter in a hollow cylindrical housing. The cutter rotates at 2000 rpm, and excised atheromatous tissue is pushed into the distal nose cone. Left: the Rotablator burr is coated with 10 μm diamond chips to create an abrasive surface. The burr, connected to a drive shaft and a turbine powered by compressed air, rotates at speeds up to 200 000 rpm
Figure 4
Figure 4
Tools for coronary atherectomy. Top: the Simpson atherocath has a cutter in a hollow cylindrical housing. The cutter rotates at 2000 rpm, and excised atheromatous tissue is pushed into the distal nose cone. Left: the Rotablator burr is coated with 10 μm diamond chips to create an abrasive surface. The burr, connected to a drive shaft and a turbine powered by compressed air, rotates at speeds up to 200 000 rpm
Figure 5
Figure 5
Coronary stents. Top: Guidant Zeta stent. Middle: BiodivYsio AS stent coated with phosphorylcholine, a synthetic copy of the outer membrane of red blood cells, which improves haemocompatibility and reduces thrombosis. Bottom: the Jomed JOSTENT coronary stent graft consists of a layer of PTFE (polytetrafluoroethylene) sandwiched between two stents and is useful in sealing perforations, aneurysms, and fistulae
Figure 5
Figure 5
Coronary stents. Top: Guidant Zeta stent. Middle: BiodivYsio AS stent coated with phosphorylcholine, a synthetic copy of the outer membrane of red blood cells, which improves haemocompatibility and reduces thrombosis. Bottom: the Jomed JOSTENT coronary stent graft consists of a layer of PTFE (polytetrafluoroethylene) sandwiched between two stents and is useful in sealing perforations, aneurysms, and fistulae
Figure 5
Figure 5
Coronary stents. Top: Guidant Zeta stent. Middle: BiodivYsio AS stent coated with phosphorylcholine, a synthetic copy of the outer membrane of red blood cells, which improves haemocompatibility and reduces thrombosis. Bottom: the Jomed JOSTENT coronary stent graft consists of a layer of PTFE (polytetrafluoroethylene) sandwiched between two stents and is useful in sealing perforations, aneurysms, and fistulae
Figure 6
Figure 6
Coronary angiogram showing three lesions (arrows) affecting the left anterior descending artery (top left). The lesions are stented without pre-dilatation (top right), with good results (bottom)
Figure 6
Figure 6
Coronary angiogram showing three lesions (arrows) affecting the left anterior descending artery (top left). The lesions are stented without pre-dilatation (top right), with good results (bottom)
Figure 6
Figure 6
Coronary angiogram showing three lesions (arrows) affecting the left anterior descending artery (top left). The lesions are stented without pre-dilatation (top right), with good results (bottom)
Figure 7
Figure 7
Exponential increase in use of intracoronary stents since 1986. In 2001, 2.3 million stents were implanted (more than double the 1998 rate)
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