Coronary angioplasty has continued to undergo important developments, both in terms of the maturation of conventional balloon angioplasty, and the favorable preliminary results of a variety of novel adjunctive techniques. To the extent that these new techniques can address the residual limitations of conventional angioplasty--and thereby improve its success, safety, and durability--angioplasty is likely to become the dominant form of myocardial revascularization in the 1990s. To ensure that this tool is applied correctly, however, careful randomized trials must be performed to establish which medical, surgical, or catheter-based treatment represents the best approach to a given clinical situation.