A Decade of Improvement in the Clinical Outcomes of Percutaneous Coronary Intervention for Multivessel Coronary Artery Disease

Twenty-five years after its tentative beginnings, percu-taneous coronary intervention (PCI) has become thedominant form of coronary revascularization. This year, the 800 000 PCI procedures are more than double the number of coronary artery bypass graft (CABG) surgeries. Although there had already been substantial growth through-out the 1980s and early 1990s as a result of improving equipment and techniques for conventional balloon angio-plasty, the accelerated growth since 1994 has clearly been fueled by the rapid adoption of coronary stenting. Today, 80 % of PCI procedures involve stent placement, supported by a series of randomized trials that have demonstrated better acute angiographic results, reduced emergency surgery, and reduced recurrence rates (restenosis) when stents are placed properly with an effective antiplatelet regimen. In practice, however, the excellent results in the circumscribed lesion types studied in the key randomized trials have been gener