ABSTRACT
Introduction Percutaneous transluminal coronary angioplasty is limited by a 3-5% incidence of abrupt coronary artery closure,1,2
indifferent clinical and angiographic results in complex or balloon-resistant lesions and a 25-35% incidence of restenosis occurring in the first six months, requiring further intervention.3-5
Directional coronary atherectomy (DCA) involves the selective excision and retrieval of atherosclerotic material from diseased coronary arteries.6-8 By debulking such arteries it was anticipated that improved results could be obtained in lesions with complex morphology, non-dilatable lesions and those in sites associated with higher complication and restenosis rates. Furthermore, it was hoped that retrieval of material might help in understanding the pathology of coronary atherosclerosis and restenosis after PTCA and perhaps also result in lower restenosis rates. Some of these hopes have been realized, but not all.
