Radiofrequency coronary angioplasty in patients with coronary artery disease - a new method for treatment of coronary artery stenoses

Balloon dilatation (PTCA) at present seems to be the standard procedure for nonsurgical coronary angioplasty in patients with clinically significant stenoses (3, 5). Despite relatively high initial success rates of up to 90% and more (1), there are many patients with stenotic lesions (e.g., eccentric, calicified or longsized) that seem to be unsuitable for balloon dilatation. Moreover, recurrency rates after initial successful PTCA are in the range of 20% –30%. This may in part be due to a traumatization of the vessel intima by the balloon inflation, which may cause the release of aggregatory and vasoconstrictor substances, as well as of proliferatory factors that result in growing of the atheroma at the site of foregoing PTCA. Lastly, with balloon angioplasty atheromatous material will not be removed or condensed as could be accomplished by atherectomy or thermal angioplasty. Therefore alternative methods of coronary angioplasty are being developed, among which radiofrequency angioplasty (4) and laser angioplasty (8) seem to be the most effective and attractive methods. Based on experimental results with radiofrequency thermal recanalization of thrombotically occluded arteries in domestic pigs (4), we have designed a new catheter system for radiofrequency coronary angioplasty in patients with hemodynamically relevant coronary artery stenoses.