COMPARATIVE-STUDY OF THE ANGIOGRAPHIC MORPHOLOGY OF CORONARY-ARTERY LESIONS TREATED WITH PTCA, DIRECTIONAL CORONARY ATHERECTOMY, OR HIGH-SPEED ROTATIONAL ABLATION

To evaluate trends in morphology-based intervention selection, series of 110 consecutive procedures of each of three devices, percutaneous t ransluminal balloon coronary angioplasty (PTCA), directional coronary atherectomy (DCA), or high-speed rotational ablation (HSRA), were revi ewed. PTCA was used mainly in discrete, concentric, smooth, ACC/AHA ty pe A and al lesions. PTCA was used less frequently on a bend, branchin g points or in calcified lesions. Using PTCA as a reference, DCA was u sed more often for the treatment of discrete, proximal, eccentric, and noncalcified lesions, often complicated with thrombus and located on straight segments. HSRA was used more frequently in diffuse, calcified multiple complicated and B2+C type lesions with frequent side branche s and bend points. These results suggest that directional atherectomy and rotational ablation may be helpful in expanding the capacity of th e operator to approach prognostically unfavorable lesions. (C) 1994 Wi ley-Liss, Inc.