Thereareseveraltechniquesforperformingcoronaryatheroscleroticplaquemodification,knownasatherectomy.Historically,clinicaltrialsshowmostlyequivalencebetweenvariouscoronaryatherectomytechniques,balloonangioplasty,andpercutaneouscoronarystenting.Inthelastseveralyearstheuseofagivenatherectomytechniquehasbeenmostlyasameansoffacilitatingstentdeliveryinvesselsthatareheavilycalcified.Noclinicaltrialshaveshownsuperiorityofanyatherectomymethodovermorestandardtechniquesofpercutaneouscoronaryintervention.Thisreviewbeginswithadiscussionofdirectionalatherectomy,whichisnolongeravailable.Therotationalatherectomytechniqueanditsclinicaltrialdataarepresented.Orbitalatherectomyisthendiscussedindetail,includingtherelevantclinicaltrials.Finally,laseratherectomytechniquesarereviewed,andthepertinenttrialdataarepresented.Lastly,futuredirectionsaredetailed.
