Two patients with new coronary stenotic lesions subsequently developed
proximal to the sites accepting directional coronary atherectomy (DCA
) are reported. One lesion developed at the left main coronary artery
and the other at the proximal segment of the left anterior descending
artery. The mechanisms of the development of such new stenotic lesions
after DCA were studied and procedure-related mechanical trauma over t
he proximal segment of the primary lesion may be the possible mechanis
m for such complication.