Directional Coronary Atherectomy versus Balloon Angioplasty

Although balloon angioplasty has been an important advance in the treatment of coronary artery disease, this procedure is limited by a high rate of restenosis. In balloon angioplasty, coronary stenoses are dilated but atherosclerotic plaques are not removed. In contrast, directional atherectomy was developed to remove atherosclerotic plaque from coronary arteries and thus overcome the problem of restenosis. Is atherectomy better than conventional balloon angioplasty? Topol and Adelman and their colleagues address this question in two randomized studies in this issue of the Journal1,2. These important studies not only examine the relative merits of directional atherectomy and balloon . . .