Evaluation of the clinical use of directional coronary atherectomy using quantitative coronary angiography

Abstract

Directional coronary atherectomy is now accepted as a feasible alternative to conventional balloon angioplasty for the treatment of coronary artery disease [1–8]. Because restenosis remains the “Achilles’ heel” of all intracoronary interventional techniques, its frequency will ultimately determine the “utility” of atherectomy. Directional atherectomy may have some theoretical advantages over balloon angioplasty in reducing the amount of intimal hyperplasia after the intervention. In theory, plaque removal may create a larger post-interventional lumen with smooth surfaces and limited elastic recoil. Whether directional atherectomy indeed has a more favorable longterm result has not been proven. Therefore, we studied the longterm results following directional atherectomy and compared them with those of balloon angioplasty, as assessed by quantitative angiography.