Equipment Selection and Techniques of Percutaneous Coronary Intervention

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.