Directional coronary atherectomy and progressive coronary dilatation: A comparative analysis of acute outcome

To evaluate the acute results and in-hospital complications of directional atherectomy (DCA) as compared to progressive coronary dilatation (PCD), we retrospectively analyzed the acute outcome of DCA with PCD in age-, sex-, vessel-, and lesion morphology—matched groups of patients during the same time span. There was a total of 73 matched patients (77 lesions) in each group. Angiographic success on the basis of intent to treat was 85% in the DCA cohort versus 97%. The preprocedural mean diameter stenosis was similar between the two groups (87% vs 84%; p = n.s.). The mean postprocedural stenosis was significantly lower with DCA than with PCD (11.2% vs 19.7%; p ≤ 0.05). Complications including death, myocardial infarction, and need for emergency bypass surgery were not statistically different in either group. In conclusion, PCD offers an alternative method of coronary intervention in patients with “atherectomy anatomy” with a significantly higher success rate. It can also be used successfully when DCA fails or cannot be performed because of technical factors.