The nonsurgical treatment of arteries narrowed by atherosclerosiswas introduced in 1964, when Dotter and Judkins performed transluminalangioplasty of femoral arterial stenoses1. In the 1970s, Gruntzigmodified the dilation catheter to allow its use in coronaryarteries,2 and in September 1977 he performed the first percutaneoustransluminal coronary angioplasty (PTCA) in a patient. PTCAhas since been used in many patients with stable angina, unstableangina, or acute myocardial infarction. Its use was initiallylimited to the treatment of discrete stenoses in proximal segmentsof a coronary artery, but improvements in equipment and techniquehave led to its . . . [Full Text of this Article]
Mechanisms of Arterial Dilation
Performance of the Procedure
Medications
The Procedure
Management after PTCA
Efficacy of the Procedure
Clinical Applications
Stable Angina on Exertion
Unstable Angina
Acute Myocardial Infarction
After Thrombolytic Therapy
Short-Term Complications
Mechanism of Abrupt Closure
Risk Factors for Abrupt Closure
Consequences of Abrupt Closure
Management of Abrupt Closure
Long-Term Complications
Mechanism of Restenosis
Risk Factors for Restenosis
Consequences of Restenosis
Management of Restenosis
Coronary Atherectomy
Economic Considerations
Future Directions
Source Information
From the Department of Internal Medicine, Cardiovascular Division, University of Texas Southwestern Medical Center, and the Cardiac Catheterization Laboratory, Parkland Memorial Hospital, Dallas.
Address reprint requests to Dr. Hillis at Room CS 7.102, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75235-9047.
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