[Percutaneous transluminal coronary angioplasty and directional coronary atherectomy: a short review of recent progress].
Since the invention of Gruentzig AR in 1977, percutaneous transluminal coronary angioplasty (PTCA) has become a widely accepted therapeutic measure for the treatment of patients with ischemic heart disease (IHD), as well as coronary artery bypass grafting (CABG). The rate of initial success in PTCA elevated up to more than 90% recently, in accordance with the progress in technology and the operator's skill. The limitations of PTCA are acute coronary occlusion which occurs in a few percent during or just after the procedure, and restenosis which occurs in thirty to fourty percent within six months. Some new devices have been invented to add better results for the patients. Directional coronary atherectomy (DCA) is one of the devices to remove atheroma in narrow segment, instead of splitting it. DCA can create a larger and smoother lumen than that created with PTCA, and it may be expected to reduce the restenosis rate. The therapeutic choice in IHD is still controversial. At present, several clinical trials are being conducted in order to evaluate and compare medical therapy, CABG, and PTCA. These results will provide informations to help the decision making in the management of the patients with IHD.
Abe
S
S
Department of Medicine, School of Medicine, Keio University, Tokyo.
Handa
S
S
D015906:Angioplasty, Balloon, Coronary; D017225:Atherectomy, Coronary / Q000379:methods*; D006801:Humans; D017202:Myocardial Ischemia / Q000628:therapy*; D012008:Recurrence