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The technique of coronary angioplasty has had a spectacular evolution since Gruentzig performed the first percutaneous coronary balloon dilation more than 15 years ago. Since then, the search for the Holy Grail has centered on alternative catheter methods, such as those involving lasers, atherectomy, and stents, to remove plaque more efficiently, which in turn would reduce the rates of initial complications and long-term restenosis. A particular milestone in this quest was reached in the fall of 1990, when the Food and Drug Administration approved the Simpson directional coronary-atherectomy device for general use. This was the first alternative method to challenge
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