coronary atherectomy has shown definite advantages over balloon angioplasty
in opening lesions that are very eccentric or at the origin of the
LAD. It permits excision and removal of atherosclerotic plaques from
proximal and mid-coronary artery sites. Acute occolusion occurs in
4% and restenosis in 30%. Risk perforation 0.7-0.9% of cases. If lesion
is not favorable for balloon dilatation (ostia lesions, lesions of
complex form, vein graft sites), directional atherectomy may help.
These lesions have resulted in the use of stents etc. (see figures