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An evidence‐based approach to the use of rotational and directional coronary atherectomy in the era of drug‐eluting stents: When does it make sense?
Author(s) -
Tran Trung,
Brown Michael,
Lasala John
Publication year - 2008
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.21676
Subject(s) - medicine , debulking , restenosis , revascularization , atherectomy , arterial disease , percutaneous , angioplasty , cardiology , coronary artery disease , coronary restenosis , percutaneous coronary intervention , surgery , radiology , stent , myocardial infarction , vascular disease , ovarian cancer , cancer
Advances in percutaneous interventions have profoundly changed the way we manage patients with coronary and peripheral arterial disease. Though the use of stents, particularly drug‐eluting stents, is the preferred method for revascularization because of ease of use and lower restenosis rates, there are many short comings. Ostial and bifurcation lesions as well as heavily calcified and tortuous arteries remain problematic. Mechanical debulking with rotational and direct coronary atherectomy may be beneficial in these situations. In this review, we present the general concepts of mechanical debulking and attempt to summarize the available data on its use in the setting of drug‐eluting stents. In addition, we will discuss its special role in the management of peripheral arterial disease. © 2008 Wiley‐Liss, Inc.