Coronary angiography and interventional cardiology.

Abstract

Percutaneous transluminal coronary angioplasty has become the most commonly applied coronary revascularization procedure. Its growth is due to expanding indications and new patient populations including patients with multivessel coronary artery disease, acute myocardial infarction or cardiogenic shock, and elderly patients. Success rates and complications for percutaneous transluminal coronary angioplasty have remained the same or improved despite the expanding indications and the persistent problem of restenosis. Several recent studies have examined new biologic approaches to restenosis. However, the most exciting area of interventional cardiology continues to be the use and development of new mechanical devices including stents, lasers, and atherectomy for unfavorable anatomic lesions, acute occlusion after angioplasty, and to prevent restenosis. The gold standard in the assessment of coronary disease is still angiography, but newer imaging techniques including intravascular ultrasound and angioscopy have added to our understanding of angioplasty, unstable angina, and the use of new devices.