The current practice of percutaneous transluminal coronary angioplasty (PTCA) and stent deployment and their long-term results in unstable and stable angina.

摘要

Percutaneous transluminal coronary angioplasty with stent implantation is a universally accepted therapeutic option for patients with coronary artery disease. Since introduction in 1977, angioplasty techniques have been greatly improved; the availability of better hardware, greater operator experience, better patient selection and the judicious use of adjunctive therapy like heparin, clopidogrel, platelet receptor antagonists like abciximab and the use of atherectomy/rotablator in given situations has greatly improved procedural outcome today. Angioplasty alleviates symptoms in patients with stable angina and also in unstable angina especially in high risk patients like those with pulmonary oedema, cardiogenic shock or patients refractory to conventional modes of therapy, though cost may be a prohibiting factor. The outcome of angioplasty in diabetic patients is universally poor and bypass surgery is always a better option. Women with coronary artery disease tend to have complex lesions with a sub-optimal outcome and a higher incidence of restenosis. Use of abciximab is always beneficial in both men and women.