Directional coronary atherectomy: a new treatment for coronary artery disease.
BACKGROUND
Directional Coronary Atherectomy (DCA) was developed to overcome the deficiencies and limitations of conventional balloon angioplasty. Now with FDA approval, DCA has been proved to be a safe and effective treatment alternative for coronary artery disease in a select group of patients.


OBJECTIVE
To provide critical care nurses with a comprehensive overview of DCA and the associated nursing implications.


METHODS
Patients selected to receive DCA were those who showed evidence of myocardial ischemia (positive exercise stress test or symptoms), were free of significant peripheral vascular disease, and were candidates for coronary artery bypass graft surgery. Additional selection criteria was based on the detailed coronary anatomy.


METHODS
A review of one direct experience of more than 200 patients treated with DCA in a university-affiliated hospital.


CONCLUSIONS
DCA appears to be a valuable alternative for the treatment of select coronary lesions. DCA appears to have a low incidence of dissection and abrupt closure and a restenosis rate slightly lower than conventional balloon angioplasty.
Cardiac Catheterization Laboratory, Beth Israel Hospital, Boston, MA 02215.
S L
SL
Borriello
S C
SC
Siegel
R F
RF
Fishman
D000368:Aged; D000369:Aged, 80 and over; D017225:Atherectomy, Coronary / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000451:nursing; D003251:Constriction, Pathologic / Q000601:surgery; D003324:Coronary Artery Disease / Q000601:surgery; D005260:Female; D006801:Humans