Equipment Selection and Techniques of Percutaneous Coronary Intervention

  • John D. Altman
  • Charanjit S. Rihal


When Gruentzig first developed balloon angioplasty in the late 1970s, generally only patients with proximal discrete single-vessel lesions could be approached [1]. As angioplasty techniques, equipment, operator experience, and adjunctive therapies improved over the years, the scope of angioplasty extended to acute coronary syndromes, multivessel disease, and higher risk categories of patients. For each patient, the question posed must be whether relief of a single stenosis or multiple stenoses is possible and desirable, and whether complete revascularization is achievable. New technology has evolved, and many new devices have been used to treat specific types of lesions. Current devices used in catheterization laboratories include directional, extraction, and rotational atherectomy, stenting (now the most predominant treatment), lasers, and filters. Use of guide catheters, wires, and balloons is necessary, and common to most devices reviewed in this chapter.


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  1. 1.
    Gruentzig AR: Transluminal dilatation of coronary artery stenosis [letter]. Lancet 1978, II:263.CrossRefGoogle Scholar
  2. 2.
    Arani DT: A new catheter for angioplasty of the right coronary artery and aorto-coronary bypass graft. Cathet Cardiovasc Diagn 1985, 11:647–653.PubMedCrossRefGoogle Scholar
  3. 3.
    Metz D, Meyer P, Elaerts J: Comparison of 6F with 7F and 8F guiding catheters for elective coronary angioplasty: results of a prospective, multicen-ter, randomized trial. Am Heart J 1997, 134:131–137.PubMedCrossRefGoogle Scholar
  4. 4.
    Simpson JB, Bairn DS, Robert EW, et al.: A new catheter system for angioplasty. Am J Cardiol 1982, 49:1216–1222.PubMedCrossRefGoogle Scholar
  5. 5.
    Talley JD, Hurst JW, King SB, et al.: Clinical outcome five years after attempted percutaneous transluminal coronary angioplasty in 427 patients. Circulation 1988, 77:820–829.PubMedCrossRefGoogle Scholar
  6. 6.
    King SB III: Angioplasty from bench to bedside. Circulation 1996, 93:1621–1629.PubMedCrossRefGoogle Scholar
  7. 7.
    Bonzel T, Wollschlager H, Meinertz T, et al.: The steerable monorail catheter system: a new device for PTCA [abstract]. Circulation 1986, 74(suppl):II-459.Google Scholar
  8. 8.
    Bonzel T, Wollschlager H, Kasper W, et al.: The sliding rail system (monorail): description of a new technique for intravascular instrumentation and its application to coronary angioplasty. Z Kardiol 1987, 76(suppl 6):119–122.PubMedGoogle Scholar
  9. 9.
    Stack RS, Quigley PJ, Collins G, et al.: Perfusion balloon catheter. Am J Cardiol 1988, 61:776–806.CrossRefGoogle Scholar
  10. 10.
    Tepel M, van der Giet M, Zikek W: Prevention of radiographic contrast-agent-induced reductions in renal function by acetylcysteine. N Engl J Med 2000,343(3):180–184.PubMedCrossRefGoogle Scholar
  11. 11.
    Seldinger SI: Catheter replacement of the needle in percutaneous arteriography: a new technique. Acta Radiol Scand 1953, 39:368.CrossRefGoogle Scholar
  12. 12.
    Chew DP, Bhatt DL, Topol EJ: Defining the optimal activated clotting time during percutaneous coronary intervention: aggregate results from six randomized, controlled trials. Circulation 2001, 103:961–966.PubMedCrossRefGoogle Scholar
  13. 13.
    Kaluski E, Krakover R, Vered Z: Minimal heparinization in coronary angioplasty—how much heparin is really warranted? Am J Cardiol 2000, 85:953–956.PubMedCrossRefGoogle Scholar
  14. 14.
    Koch KT, Piek JJ, Lie KI: Safety of low-dose heparin in elective coronary angioplasty Heart 1997, 778:517–522.Google Scholar
  15. 15.
    O’Shea JC, Hafley GE, Tcheng JE: Platelet glycoprotein IIb/IIIa integrin blockade with eptifibatide in coronary stent intervention: the ESPRIT trial: a randomized controlled trial. JAMA 2001, 285:2468–2473.PubMedCrossRefGoogle Scholar
  16. 16.
    The EPIC Investigators: Use of a monoclonal antibody directed against the platelet glycoprotein IIb/IIIa receptor in high-risk coronary angioplasty. N Engl J Med 1994, 330:956–961.CrossRefGoogle Scholar

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© Springer Science+Business Media New York 2003

Authors and Affiliations

  • John D. Altman
  • Charanjit S. Rihal

There are no affiliations available

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