Primary directional coronary atherectomy for acute myocardial infarction

The effectiveness of primary coronary angioplasty for acute myocardial infarction (AMI) is now widely recognized. However, the reocclusion rate is as high as 10%. Directional coronary atherectomy (DCA), now used widely in the treatment of stable and unstable angina pectoris, has not been recommended as the primary reperfusion therapy for AMI. This report describes the first preliminary study of primary DCA for AMI without any antecedent thrombolytic therapy or balloon coronary angioplasty. Five patients received primary DCA. The initial results were very good, but further study is necessary to determine the efficacy, particularly the long-term results, of primary DCA in the treatment of AMI.