Percutaneous transluminal atherectomy of the peripheral and coronary arteries

Abstract

Since the first coronary angioplasty was performed in 1977 by Gruentzig, angioplasty has gained wide acceptance as a treatment for coronary artery disease. Angioplasty is a less invasive and less costly alternative to bypass surgery and has a lower morbidity. Over the last decade improvements in the equipment have allowed for expanded indications for angioplasty, thereby increasing the number of patients able to be treated with this procedure. Angioplasty, however, has been plagued with a recurrence rate of approximately 30%, as well as acute occlusions resulting from dissections. In addition, eccentric lesions do not respond well to angioplasty and hard, fibrous or calcified lesions often fail to dilate. Atherectomy is one of several new techniques currently being developed to address these shortcomings.