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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)
See this image and copyright information in PMC

References

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    1. Smith SC Jr, Dove JT, Jacobs AK, Kennedy JW, Kereiakes D, Kern MJ, et al. ACC/AHA guidelines of percutaneous coronary interventions (revision of the 1993 PTCA guidelines)-executive summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (committee to revise the 1993 guidelines for percutaneous transluminal coronary angioplasty). J Am Coll Cardiol 2001;37: 2215-39 - PubMed
    1. Meyer BJ, Meier B. Percutaneous transluminal coronary angioplasty of single or multivessel disease and chronic total occlusions. In: Grech ED, Ramsdale DR, eds. Practical interventional cardiology. 2nd ed. London: Martin Dunitz, 2002: 35-54
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