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A Spirited Step Forward or More of the Same

Manesh R. Patel, MD; David R. Holmes Jr, MD

JAMA. 2008;299(16):1952-1953.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The great reward for practicing interventional cardiologists is the ability to help patients live longer as well as to reduce their symptoms and improve their quality of life.¹

These objectives have been central since Gruentzig performed the first percutaneous balloon angioplasty in 1977.² In an effort to demonstrate the safety and effectiveness of angioplasty, Gruentzig and other pioneers focused their initial studies on carefully selected patients with rigorous longitudinal follow-up.^3-4 Gruentzig selected patients with less complex coronary stenosis, often single-vessel disease, to perform the "proof-of-concept" initial evaluation of angioplasty.⁵ These studies validated the concept that angioplasty relieved angina for patients with coronary stenosis.

During this early era, however, percutaneous angioplasty was frequently complicated by abrupt vessel closure and repeat intervention, often for restenosis.⁶ Thus, percutaneous angioplasty was found to have potential beneficial effects in terms of symptom relief, yet these benefits . . . [Full Text of this Article]

Author Affiliations: Duke Clinical Research Institute, Duke University, Durham, North Carolina (Dr Patel); and Mayo Clinic, Rochester, Minnesota (Dr Holmes).

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