DIRECTIONAL CORONARY ATHERECTOMY AND PROGRESSIVE CORONARY DILATATION - A COMPARATIVE-ANALYSIS OF ACUTE OUTCOME

To evaluate the acute results and in-hospital complications of directi onal atherectomy (DCA) as compared to progressive coronary dilatation (PCD), we retrospectively analyzed the acute outcome of DCA with PCD i n 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 be tween 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 less than or equal to 0.05). Com plications including death, myocardial infarction, and need for emerge ncy bypass surgery were not statistically different in either group. I n conclusion, PCD offers an alternative method of coronary interventio n in patients with ''atherectomy anatomy'' with a significantly higher success rate. It can also be used successfully when DCA fails or cann ot be performed because of technical factors.