[Role of atherectomy devices in interventional cardiology]

Abstract

Background: Unsatisfactory results and restenosis rates of up to 70% in complex coronary lesions created the necessity for alternative methods of percutaneous revascularization. Debulking of excess tissue seemed a promising approach in comparison to conventional PTCA. Most frequently used techniques included directional coronary atherectomy (DCA), laser angioplasty (ELCA), and rotational atherectomy (rotablation, RA). Neither of these techniques managed to establish a clear advantage over conventional PTCA so that they are indicated only under special circumstances. Even in a randomized controlled comparison of PTCA and rotablation in the treatment of in-stent restenosis, rotablation failed to show a clear advantage.

Aim: This review aims to give an overview over currently used atherectomy techniques and their role in interventional cardiology.