PTCA was performed in 166 patients older than 70. The primary angiographic and clinical success rates were 85% and 86%, respectively. A total of 15 major complications occurred in 10 patients (6%): 4 patients died (2%), 6 patients underwent urgent bypass surgery (4%), the incidence of acute myocardial infarction was 3% (5 patients). The 4-year survival rate was 84 +/- 8%. During the follow-up period 8 patients (5%) sustained a nonfatal myocardial infarction, 21 patients (13%) underwent a second and (or) third balloon dilatation and 17 patients (10%) underwent bypass surgery. At the end of the observation period 68% of the survivors had a sustained improvement of the functional class. This was associated with a significant reduction of the antianginal therapy. These data demonstrate that PTCA can be performed safely and effectively in patients over 70.