Two Decades of Percutaneous Transluminal Coronary Angioplasty Practice by a Single Operator in India: Insights and Long-Term Outcomes

Objectives: To explore and analyze a single operator’s experience in performing percutaneous transluminal coronary angioplasty (PTCA) with respect to procedural technique, patient characteristics, and procedural outcomes. Methods: This retrospective analysis includes follow-up data of 3070 patients who underwent PTCA in Hyderabad, India, between 2000 and 2024. Stent implantation was performed via radial, femoral, or ulnar access with or without the aid of imaging techniques. Bare metal stents (BMS), drug-eluting stents (DES), and bioresorbable vascular scaffolds (BVS) were used to achieve reperfusion. Outcomes including repeat revascularizations, coronary artery bypass graft, and mortality were recorded. Descriptive statistics were used for analysis. Results: The mean age of the patients was 58.2 ± 12.1 years and 78.6% were males. Hypertension (66.25%) and diabetes (50.49%) were the most common comorbidities among patients. PTCA was performed in the LAD in 58.44% of patients. Before 2005, BMS was deployed in 100% of the cases. After 2005, there was a temporal shift from BMS to DES where DES was used in 87.3% of the cases, while BMS in 9.6%, and BVS in 0.6%. Overall, DES was the most commonly deployed stent (88.86%) and BMS was deployed only among 10.1% of the patients. The rate of overall mortality and revascularization was 6.55% and 2.08%, respectively. Revascularization (11.6% vs. 4.0%) and mortality (17.1% vs. 5.9%) were highest with BMS and lowest with DES. Follow-up data of 25% of patients were not recorded. Conclusion: This is the first single-operator experience using PTCA with 20-year follow-up data analyzed in India. The findings revealed a declining incidence of repeat revascularization and mortality across 20 years due to evolving stent technologies and operator expertise.