[Coronary angioplasty at the dawn of the 21st century].

In about 20 years, transluminal coronary angioplasty has become the most commonly used method world wide for revascularisation. During this short period, the technique has progressed from a problematical technique reserved for rare privileged indications to reliable, safe therapy, the primary results of which are predictable with the widespread use of coronary stents. These rapid strides were made possible by material innovations, the progression of radiological and echographic imaging and, above all, by the professionalism and experience of interventional cardiologists. Besides the immediate impact on the safety of the procedure and quality of the immediate result, the implantation of stents also reduces the risk of restenosis in the long-term. However, the risk is not totally eliminated because although the stent prevents the constrictive scarring remodelling of the dilated artery. It also exacerbates the fibroproliferative phenomena which now play a dominant part in the mechanisms of restenosis. The efforts of research are now directed towards this target: in situ drug delivery, gene therapy, brachytherapy.