Interventional cardiology is an iterative science. Advances come in spurts as interventionalists gradually become increasingly familiar with its technologies and limitations. This iterative learning process in the use of percutaneous coronary intervention (PCI) has been tremendous over the last 3 decades. While adverse events were frequent and restenosis was common in the first decade, PCI procedures did relieve symptoms for patients with coronary disease. In the second decade of PCI use, new techniques were developed to scrape, burn, or excise plaque, in an attempt to achieve better outcomes. While there was much hope and hype with these approaches, they all had fundamental problems that prevented their broader use.
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