I. Procedure
II. Indications
III. Contraindications and Limitations
IV. Outcome of Angioplasty

GLOSSARY
angina pectoris short duration, recurrent chest pain or pressure often accompanied by feelings of suffocation and impending doom; most frequently associated with lack of blood and oxygen to the heart muscle.
atheroma same as atherosclerosis, raised plaques filled with cholesterol, calcium, and other substances on the inner wall of arteries that obstruct the lumen and the flow of blood; the plaque of atheroma hardens the artery, hence the term atherosclerosis (sclerosis ¼ hardening).
ejection fraction the fraction of blood ejected from the heart into the arteries, normally this ranges from 60 to 75%; a low ejection fraction is less than 40%; often used as a marker of left ventricular contractility.
ischemia temporary lack of blood and oxygen to an area of cells, for example, the heart muscle, usually due to severe obstruction of the artery supplying blood to this area of cells.
myocardial infarction death of an area of heart muscle caused by blockage of a coronary artery by blood clot and atheroma; medical term for a heart attack or coronary thrombosis.
myocardium the heart muscle.
THE FIRST SUCCESSFUL CORONARY ANGIOPLASTY was performed by the late Dr. Andreas Gruntzig in Zurich, Switzerland, in 1977. Dr. Gruntzig pioneered the modern era of interventional cardiology with his innovative percutaneous transluminal coronary angioplasty (PTCA). Using a double-lumen balloon catheter, he performed the first PTCA by dilating the proximal left anterior descending coronary artery and unblocking an atheroma-tous obstruction of a 37-year-old man with angina. Repeat angiograms on the 10th anniversary of this procedure showed continued vessel patency; the patient has remained symptom-free for more than 20 years.

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• I. PROCEDURE
  
• II. INDICATIONS A. Stable Angina
  Patients with bothersome stable angina who do not achieve sufficient relief with medical therapy are candidates for coronary angioplasty, if they have any of the following:
• III. CONTRAINDICATIONS AND LIMITATIONS
  Below is a list of contraindications and limitations for angioplasty.
• IV. OUTCOME OF ANGIOPLASTY
  Successful reopening of the artery is achieved in greater than 90% of cases, and with better blood flow, angina improves. The majority of patients return to work a few days later and have no recurrence of the angina for at least six months. Early complications are most often the result of abrupt vessel closure, defined as sudden occlusion of the target vessel during or shortly after PCI. This occurs in less than 2% of patients. The pathophysiology involves local vessel dissection with obstructive resection flaps accompanied by thrombus formation. This process usually leads to myocardial infarction and need for bail-out stent or bypass surgery. The recent use of platelet IIb/IIIa receptor blockers and stenting has reduced the incidence of adverse outcomes of acute vessel closure.
• BIBLIOGRAPHY
  Chieffo, A., Stankovic, G., Bonizzoni, E. et al. Early and mid-term results of drug–eluting stent implantation in unprotected left main. Circulation, 111:791-795, 2005.