Guidelines for training in percutaneous transluminal coronary angioplasty (PTCA). Report of The Council of the British Cardiovascular Intervention Society (BCIS).

Correspondence to Dr H H Gray, Wessex Cardiac Unit, Southampton General Hospital Southampton S09 4XY Coronary heart disease is responsible for considerable morbidity and is the single most common cause of death in the United Kingdom. Coronary artery bypass grafting (CABG) and percutaneous transluminal coronary angioplasty (PTCA) are of proven symptomatic benefit, and CABG improves prognosis in certain subgroups of patients. As preventive measures become more widely accepted the incidence of ischaemic heart disease may decrease but despite such a decrease the demand for revascularisation procedures (CABG or PTCA) will continue to rise for the foreseeable future. There are several reasons for this: the provision of cardiological services at district level is slowly improving, more patients are surviving myocardial infarction because of the use of thrombolytic agents, and there is increasing awareness of the benefits of revascularisation procedures. With advances in technology and operator experience the results of PTCA have improved, allowing more complex coronary artery disease to be treated in this way. Finally, as the number of patients who have had revascularisation procedures in the past increases, so the number potentially requiring re-investigation for recurrent symptoms will rise in the future. Factors such as these will increase the number of referrals to centres providing revascularisation procedures and for this demand to be met an adequate number of PTCA operators must be trained.' PTCA is a skilled procedure with success, failure, and complications relating to the operator's expertise and judgement and it is therefore essential that those wishing to undertake angioplasty are properly trained. This article provides guidelines aimed at optimising such training. As with other aspects of medicine it is the responsibility of all doctors performing PTCA, and particularly those training others in the technique, to ensure that in their institution the procedure can be performed safely and with a high likelihood of success.