Recommendations of the Joint International Society and Federation of Cardiology/World Health Organization Task Force on PTCA
A decade has passed since Grüntzig performed the first coronary angioplasty in Zurich. As the initial reports of that experience became widely known, they were greeted with both wonderment and scepticism. Wonderment because the angiographic changes and the pressure gradient measurements established that a remarkable reduction in the degree of obstruction could be produced. Scepticism because initially the mechanism through which this was accomplished was obscure. Furthermore, there were fears of all sorts of disastrous complications. These included downstream embolization, large coronary dissections that would lead to closure or even rupture of vessels, immediate thrombosis or spasm with resultant myocardial infarctions, episodes of late spasm, and even fear that splitting of the fibrous cap of the atherosclerotic lesion would result in accelerated atherogenesis in the future. There were also concerns regarding the likelihood of restenosis. These latter have proven to be justifiable and serve to limit the benefits of the procedure. Nevertheless, as experience accumulated, initially by Grüntzig and his early collaborators, Kaltenbach in West Germany, Stertzer in New York, and Myler in San Francisco, it became evident that the procedure was an innovative and important therapeutic intervention.
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