What is the use of directional atherectomy, now we have stents?

Coronary in-stent restenosis: current status and future strategies.

In-stent restenosis (ISR) is a novel pathobiologic process, histologically distinct from restenosis after balloon angioplasty and comprised largely of neointima formation. As percutaneous coronary intervention increasingly involves the use of stents, ISR is also becoming correspondingly more frequent. In this review, we examine the available studies of the histology and pathogenesis of ISR, wit...

Classification and current treatment options of in-stent restenosis. Present status and future perspectives.

Coronary stent implantation is currently performed in > 80% of percutaneous coronary interventions. Its main late complication is the development of in-stent restenosis (ISR), occurring in 10-80% of lesions treated in daily practice. The classification by Mehran et al. is most commonly used. Current therapeutic options to treat ISR include repeat balloon angioplasty, repeat stenting, cutting ba...

Interventional cardiology. The decade ahead.

B alloon angioplasty, arguably cardiology's most important advance of the decade past, now suffers from what we will call the 5-45-50 problem: 5% acute closure,' 45% restenosis,2,3 and 50% unsuitable coronary anatomy. We are now beginning to see the first publications describing multicenter experiences with three types of devicesatherectomy, lasers, and stents-originally designed to reduce the ...

Directional Atherectomy for Treatment of Restenosis Within Coronary Stents: Clinical, Angiographk and Histologic Results

Silent very late thrombotic occlusion of sirolimus-eluting stent confirmed by directional coronary atherectomy.

Stent thrombosis is defined as thrombotic occlusion of a stent resulting in acute coronary syndrome (ACS). However, all thrombotic occlusions of stents might not result in ACS. The present case report describes silent, very late thrombotic occlusion of a drug-eluting stent that was confirmed from specimens removed by directional coronary atherectomy.