Percutaneous transluminal coronary angioplasty (PTCA).

The role of PTCA in the management of coronary artery disease has continued to evolve during the past six years as experience has grown and technical advances have been made. As has been clearly demonstrated in its relatively short history, PTCA offers an effective means of immediate palliation in symptomatic coronary artery disease. The natural history of coronary artery disease is one of progression and the ideal therapy is one which can be used repeatedly through the years. Advances in diagnostic technique hopefully will enable physicians to intervene earlier in the course of the disease, prior to the compromise of ventricular function which often accompanies triple vessel disease. The main question, however, is still unanswered and that is whether PTCA is an alternative approach to coronary artery bypass graft surgery in patients with multivessel disease. Preliminary reports indicate safety and good results may be obtained when PTCA is performed in these patients. However, the true usefulness and exact role needs to be carefully determined in a randomized study comparing coronary artery bypass surgery and PTCA in patients with multivessel disease. Hopefully in the future, patients with coronary artery disease can be diagnosed early before their disease progresses to severe triple vessel disease, when it may be too late for PTCA.