Acute complications of coronary angioplasty: Prevention and management.

The immediate results of transluminal coronary angioplasty (TCA) have impro ved considerably during recent years. Balloon dilatation of the arterial st enosis is the basis of this technique of revascularisation but neww tools m ay be used to treat specific lesions. Coronary occlusion is the most feared complication of TCA. It may cause myo cardial infarction or death of the patient. It is usually secondary to diss ection and/or thrombus of the artery. The implantation of a stent successfu lly treats most cases of dissection, New anti-platelet (GP IIb/IIIa) drugs seem to be very effective in the prevention and treatment of the thrombosis . The systematic use of ticlopidine limits the risk of stent occlusion. Imp roved features enable satisfactory implantation of stents in the majority o f cases. In some patients, the clinical consequences of occlusion may be li mited by vascular bypass techniques, especially intra-aortic balloon pumpin g. In other cases, emergency coronary bypass surgery may be necessary. When TC A is considered to be a very high risk procedure, effective surgical cover is essential.