Key result
A newly developed directional coronary atherectomy (DCA) catheter was approved in Japan in 2014, prompting a review of its potential role for bifurcated lesions in the drug-eluting stent era.
The revived directional coronary atherectomy (DCA) catheter, when used with IVUS guidance, offers a specialized approach for treating complex bifurcated coronary lesions in the drug-eluting stent era by mitigating carina shift.
Directional coronary atherectomy (DCA) was developed in 1990 in the USA and expected to reduce the abrupt closure rate and the late restenosis of balloon angioplasty. However, the first large randomized clinical trial (CAVEAT study)1) failed to demonstrate the superiority of DCA compared to balloon angioplasty. Coronary stents became available in 1994 and were widely accepted, because stenting was simple, easy to perform, and effective. In addition, after the drug-eluting stent became available, DCA device users declined with the DCA catheter removed from the device market in 2008. On the other hand, there were some Japanese cardiologists, who strongly desire to revive the DCA device. They reported in 2007 that DCA was useful for limited patients, especially for bifurcated lesions including left main trunk (PERFECT Study)10). A new DCA catheter has been developed by NIPRO Corporation (Osaka, Japan) and was approved by the Japan Ministry of Health, Labor and Welfare in December 2014. This article introduces the newly developed DCA catheter and considers the role of this device in the drug-eluting stent era.
No takes yet. Share an insight, caveat, or question.
Mikihiro Kijima (2016) conducted a review in Coronary artery disease. Directional coronary atherectomy (DCA) was evaluated. A newly developed directional coronary atherectomy (DCA) catheter was approved in Japan in 2014, prompting a review of its potential role for bifurcated lesions in the drug-eluting stent era.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: