New technologies in interventional cardiology.

New technologies for interventional cardiology include metallic intraluminal supports (stents), mechanical devices used for plaque removal (atherectomy), and photoablative devices (lasers). Several individual devices in each category are in active clinical investigation and appear to provide safe and effective treatment for many problems that have continued to plague conventional balloon angioplasty. These include failure to dilate eccentric, rigid, or diffuse stenoses; abrupt closure of the dilated segment; and restenosis after successful dilatation. Working with these devices, physicians have learned not only how to use them optimally but a great deal about the biology of restenosis and the manner in which new interventional devices should be evaluated. Although none of the new technologies is likely to replace balloon angioplasty, which has demonstrated broad applicability, success, and safety, the selective use of new devices seems certain to enhance the possibilities for percutaneous transluminal revascularization.