Restenosis after coronary angioplasty: a proposal of new comparative approaches based on quantitative angiography

Recurrence of coronary artery stenosis or "restenosis" is now well established as the main limitation of percutaneous transluminal coronary angioplasty (PTCA), which was first used by Gruentzig in 1977.'However, despite the increasing popularity and application of the percutaneous approach to coronary revascularisation as an attractive alternative to coronary artery bypass graft surgery and the apparent frequency of lesion recurrence there is still no satisfactory universally accepted "definition of restenosis" (table).2"'New devices for percutaneous coronary recanalisation (endoluminal coronary stent implantation; directional, extractional, or rotational atherectomy; laser balloon angioplasty; and excimer laser) have up to now, failed to provide better long term outcome than balloon angioplasty.""'7but they have stimulated the search for universally applicable, objective methods of assessing the new methods and of comparing them with conven- tional balloon angioplasty and with each other Thoraxcenter, in terms of the immediate and long term effects Erasmus University, on treated vessels.'5Rotterdam, Nearly all the early reports on restenosisThe Netherlands after angioplasty relied on visual or user-