[Future of interventional cardiology in the treatment of XXXX ].

@entity1 @entity66 @entity6 @entity583 @entity256 @entity453 @entity850 @entity1211
BACKGROUND: The development of interventional cardiology (PCI) started already with the introduction of catheterization but was pushed forward by A. Gr  ntzig with the percutaneous transluminal coronary angioplasty (PTCA) 1977. In the beginning very slow progress could be observed. This changed when Gr  ntzig changes to Emory university, Atlanta. Already after 10 years alternative techniques were introduced like stent implantation and rotablation, coronary atherectomy, laser angioplasty, ultrasound therapy. During the following years, it became obvious that only for stent implantation (see W. Rutsch et al, Berlin, p.481) and rotablation (see T. Dill et al, Bad Nauheim, p.502) standard indications could be seen in addition to PTCA. Brachytherapy for treatment of in stent restenosis and laserwire recanalisation of occluded vessels were added. NEW METHODS: New protection systems - aspiration or filters - were introduced for increase of PCI safety in @entity1211 (see C. Hamm et al, Bad Nauheim, p.527). The main step forward seems to be the introduction of drug eluting covered stent either with polymer (see E. Grube et al, Siegburg, p.508) or ceramic coating (see H. Wieneke et al, Essen, p.518). @entity256 rates, which were already reduced by bare stent for 20-30%, could be lowered below 10%. RESULTS: In @entity1 with @entity6 and main stem @entity850 or multi @entity66 , @entity453 bypass surgery is indicated, but in other @entity1 PCI seems to be as good as surgery in relation to mortality and @entity583 rates. With drug eluting stents the role of PCI may become even more pronounced, because the revascularization rate could be further reduced (see W. Rutsch, Berlin, p.481). CONCLUSION: The future will demonstrate even further main steps for interventions like the percutaneous bypass attempts and the introduction of gen-therapy (A. B. Buchwald, G  ttingen, p.533). Meanwhile we can observe a drop of 1-2% mortality in @entity453 related to 60% influence of prevention and 40% to advanced PCI therapy. This is still a remarkable successful story in medicine provided by cardiology.
