Percutaneous transluminal angioplasty: surgeon's view

The balloon-tipped catheter for percutaneous transluminal angioplasty (PTA) is a potentially dangerous weapon. Safe use requires considerable technical skill. Complications have already caused significant risk to, and loss of, limbs and life. Although there is no question that the incidence of successful dilatation in competent hands is quite high, the risks of complication are still not completely known. Any new procedure must be compared with existing effective modes of treatment, in this case, surgical revascularization. Therefore, this new procedure must be examined and compared in terms of acute hemodynamic effectiveness, mortality and morbidity, specific indications, long-term results (durability), and consequences of long-term failure. Pertinent surgical experience is reported to provide data for this comparison and information from which some predictions about percutaneous angioplasty can be made. Although complete information about these issues is needed before we can confidently accept balloon catheter angioplasty as a therapeutic procedure and assign it its proper role, cautious and judicious application of angioplasty should proceed with some definite guidelines.