When and why should we employ the interventional cardiologist

Percutaneous coronary intervention (PC!) represents a "success story"' of modern cardiology. In the wake of its enormous growth, large-scale registries and trials have established that PCI is effective in relieving ischemia and symptoms, safe, and "comfortable." Its best indications are the severe forms of ischemia, in particular high-risk acute coronary syndromes and stable angina pectoris with severe ischemia. Its efficacy is highly dependent on the skill of the interventional clinician and the centered experience, both in terms of the technical requirements of the procedure itself as well as of the highly sophisticated adjunctive antithrombotic therapies used before, during, and after the procedure. However, this success should not detract from the need for careful selection of indications and assessment of outcomes.