[Coronary angioplasty: view through 30 years]

Abstract

Andreas Gruentzig executed the first successful percutaneous transluminal coronary angioplasty (PTCA) in 1977. Percutaneous coronary interventions (PCI) have considerably changed since this time. The changes have touched the technical equipment for PCI, the pharmacological and mechanical support of PTCA also. The serious revision was in recommendations for PCI too. New catheter technologies have allowed to perform successful PCI in patients with an acute myocardial infarction, with multivessel coronary disease and in many others. PCI became the most often method of a coronary revascularization for ischemic heart disease in the nineties. Percutaneous interventions pass ahead of coronary artery bypass graft operations in many countries of Europe and America. The coronary angioplasty is carried out more than in 2 million patients in the world annually, and 1 million patients is exposed to the PCI annually in the USA. Coronary stenting became most frequently used technology of PCI from the middle of the nineties. The implantation of drug-eluting stents has been the dominating catheter-based method in world clinical practice during last three years. Nevertheless, both these technologies are not deprived of restrictions and disadvantages. The coronary restenosis has become the main limitation for standard (bare-metal) stents, and late thrombosis has become the most terrible complication for the drug-eluting stents. The big success of a method and huge increase of quantity of coronary interventions would be impossible without sequence of openings, innovations and other important events which are surveyed in this review.