Balloon angioplasty.

Balloon angioplasty of the coronary arteries is about 20 years old and has become the main technique of myocardial revascularisation. It is performed under local anaesthetic by arterial puncture and some centres are already p erforming the procedures on an ambulatory basis. Optimally, the procedure should be performed in a well-equipped catheter la boratory with trained operators and experienced personnel. The most impressive results are obtained in single vessel disease. However, double and triple vessel disease may also be treated, especially in elderl y, frail patients, in cases of high surgical risk or with a previous histor y of coronary bypass surgery. Balloon angioplasty has an important role in the treatment of acute myocardial infarction, either as an alternative or a s a complement to thrombolytic therapy. The major limitations of this technique, in the absence of stenting, are th e failure to pass chronic lesions, the occurrence of major complications in about 1% of cases, of acute occlusion in about 5% of cases, and, finally, of restenosis estimated between 30 and 50%, depending on the publication. In the general population, the success rate is over 95% with an immediate r eturn to normal life and the possibility of repeating an angioplasty in cas es of restenosis. Coronary stents are a major technical adjuvant to balloon angioplasty and t he indications of their implantation have exceeded 50% of procedures in rec ent years.