PTCA expands the coronary lumen by stretching and tearing the atherosclerotic plaque and vessel wall and to a lesser extent, by redistributing atherosclerotic plaque along its longitudinal axis. There is no evidence that the balloon compresses atheromatous plaques. PTCA has been transformed in the past decade with the development of angioplasty to assist with lesions exhibiting complex characteristics. The term percutaneous coronary interven¬tion (PCI), is now used to include angioplasty with or without stent deployment. More than 700,000 patients in the United States had PCIs in 2004, far exceeding the number of patients who had coronary artery bypass graft (CABG) surgery. This method of treating coronary heart disease (CHD) is available in most major medical centers worldwide.
Atherosclerosis, however, usually affects several segments of the coronary arteries. As the disease advances, every effort must be made to halt its progress. All risk factors — smoking, high blood pressure, stress, cholesterol higher than 200 mg (5.2 mmol), and LDL cholesterol higher than 100 mg/dl (2.5 mmol) — must be controlled. Diet plus drug therapy is usually necessary to achieve this goal (see chapter entitled ‘‘Dyslipidemia.’’)

Страницы: 1 | 2