Coronary Atherectomy

Neil J. Weissman, M.D., and Arthur E. Weyman, M.D.

N Engl J Med 1994; 330:539February 24, 1994

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Figure 1 Coronary Atherectomy.

A proximal stenosis of the left anterior descending coronary artery (arrow in Panel A) was found in a 41-year-old man during coronary arteriography for unstable angina. The stenosis improved after atherectomy (Panel B). Intravascular ultrasonography was performed before and after atherectomy. Before atherectomy a plaque occupies the entire artery and closely surrounds the ultrasound catheter (Panel C and Panel D). After atherectomy the size of the lumen has increased and the area of the plaque has decreased (Panel E and Panel F). Although the intervention appears to have resulted in a normal vessel with no evidence of stenosis on angiography, the intravascular ultrasound images reveal a substantial amount of residual plaque.

Kim Eagle, M.D.

Neil J. Weissman, M.D.
Arthur E. Weyman, M.D.
Massachusetts General Hospital, Boston, MA 02114

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