Chapter

Percutaneous coronary intervention

Dr Nalyaka Sambu and Nicholas Curzen

in Landmark Papers in Cardiovascular Medicine

Published on behalf of Oxford University Press

Published in print September 2012 | ISBN: 9780199594764
Published online November 2012 | e-ISBN: 9780191753480 | DOI: http://dx.doi.org/10.1093/med/9780199594764.003.0006

Series: Landmark Papers in

Percutaneous coronary intervention

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Over the past three decades, there have been major advances in the field of interventional cardiology that have revolutionized the treatment of coronary heart disease (CHD). Grüentzig and Myler performed the first coronary angioplasty in 1977 and, since then, the practice of percutaneous coronary intervention (PCI) has undergone a dramatic transformation brought about by:

♦ the transition from balloon angioplasty to drug eluting stents.

♦ the use of adjunctive techniques during PCI such as the pressure wire, intravascular ultrasound, rotablator, laser, and the manual aspiration catheter.

♦ the redundancy of thrombolytic therapy and its replacement with primary PCI as the gold-standard treatment for ST-elevation myocardial infarction (STEMI).

♦ a shift in focus away from PCI driven by angiographic lesion severity towards ischaemia-driven intervention instead.

♦ the development and widespread use of more potent and effective antiplatelet and antithrombotic agents, including more rigorous therapeutic regimes.

♦ the role of PCI as first line revascularization strategy in patients with more complex coronary disease who would have traditionally undergone coronary artery bypass surgery.

The vast body of clinical research in interventional cardiology over the years has led to a significant expansion in the envelope of patients referred and accepted for PCI due to significant improvements in techniques, devices, and adjunctive pharmacotherapy. This chapter describes some of the truly landmark papers in the field of interventional cardiology that have had a clinical impact on our everyday practice. Of note, we have not specifically discussed landmark studies comparing PCI versus coronary artery bypass surgery as this is discussed in detail in Chapter 7.

Chapter.  8641 words.  Illustrated.

Subjects: Cardiovascular Medicine ; Interventional Radiology

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