Problems in the development of new devices for coronary intervention: possible role for a multicenter registry.

transluminal coronary angioplasty (PTCA) was developed 12 years ago, it was seen as a limited technique applicable to no more than 5% to 10% of the patients undergoing coronary bypass surgery. However. over the last 5 years improvements in angioplasty equipment and technique have allowed balloon angioplasty to expand to the point where more than 200,000 coronary angioplasties were performed in 1988, accounting for more than one half of total coronary revascularization procedures (angioplasty or bypass surgery) (I ). At the same time, procedural success has improved (from 65% to 85%) and the need for emergency bypass operations has fallen (from 6% to 2%) (2). even though coronary angiolasty is now being applied in progressively more difficult anatomic and clinical situations. This rapid acceptance of coronary angioplasty by the medical community has been facilitated by the perception that angioplasty is (in selected patients) a less invasive and less costly means of revascularization than the alternative surgical bypass procedure.