Advertisement

Learning curve for percutaneous transluminal coronary angioplasty: Skill, technology or patient selection

      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      As with all sophisticated techniques, operators who perform PTCA show a learning curve. It can best be visualized by observing changes in success rate with growing numbers of patients. Thus, the current success rate and complication rate of a particular operator may permit an estimate of the accumulated number of patients treated by that operator. Most likely, the learning curve is also reflected in the rate of long-term success, although it may be obscured by other factors in the variable natural course of CAD. The initial steep upslope of the learning curve is mainly caused by the growing skill of the particular operator. The later, flatter part appears to be secondary to improvements in technical equipment, which take more time. Patient selection has 2 effects on the learning curve that may be self-compensating. If lessons from the past are used for selection and conservatism is preserved, the learning curve will become more pronounced.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Cardiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Dorros G
        • Cowley MJ
        • Simpson J
        • Bentivoglio LG
        • Block PC
        • Bourassa M
        • Detre K
        • Gosselin AJ
        • Greuntzig AR
        • Kelsey SF
        • Kent KM
        • Mock MB
        • Mullin SM
        • Myler RK
        • Passamani ER
        • Stertzer SH
        • Williams DO
        Percutaneous transluminal coronary angioplasty: report of complications from the National Heart, Lung, and Blood Institute PTCA Registry.
        Circulation. 1983; 67: 723-730
        • Simpson JB
        • Baim DS
        • Robert EW
        • Harrison DC
        A new catheter system for coronary angioplasty.
        Am J Cardiol. 1982; 49: 1216-1222
        • Gruentzig AR
        • Hollman J
        Improved primary success rate in transluminal coronary angioplasty using a steerable guidance system (abstr).
        Circulation. 1982; 66: II-330
        • El Gamal MIH
        • Bonnler H
        • Michels R
        A new guiding catheter for intubating aortocoronary bypass grafts by the femoral approach.
        in: Kaltenbach M Gruentzig A Rentrop K Bussmann WD Transluminal coronary angioplasty and intracoronary thrombolysis. Coronary heart disease IV. Springer-Verlag, Berlin1982: 174-175