Forsyth Medical Center 
Tests and Treatments
Directional Coronary Atherectomy (DCA)
| DCA is a procedure that treats specific types of narrowing in the coronary artery. |
Directional Coronary Atherectomy is a non-surgical technique that is used to widen and open the narrowing in the coronary artery.
Usually, the decision to proceed with DCA is made directly after a coronary angiogram while a patient is the catheterization lab. Occasionally, the procedure occurs later that day or the next day. DCA can be preferable to other procedures, such as balloon angioplasty. Some of the factors that determine angioplasty versus atherectomy are the location and shape of the blockage, the size of the artery, and whether clots are present in the artery. Your cardiologist will determine which procedure best fits your case.
Usually, the decision to proceed with DCA is made directly after a coronary angiogram while a patient is the catheterization lab. Occasionally, the procedure occurs later that day or the next day. DCA can be preferable to other procedures, such as balloon angioplasty. Some of the factors that determine angioplasty versus atherectomy are the location and shape of the blockage, the size of the artery, and whether clots are present in the artery. Your cardiologist will determine which procedure best fits your case.
How it works
A catheter is inserted through an incision, usually in the groin, and is directed to the opening of the diseased artery. Once the catheter is in place, the atherectomy device is inserted through this catheter, which can be seen with X-ray and is viewed as it moves across the narrowed area. Depending on the narrowing of the artery, a small angioplasty balloon may be used to allow easier passage of the atherectomy device.
Once in position, the cardiologist inflates a balloon that presses a small metal window against the blockage in the artery. A cutting device released through this window shaves off the blocking tissue. When the procedure is complete, normal blood flow is reestablished to the previously blocked artery.
The expandable walls of the artery can withstand the pressure of balloon inflation and tissue shaving without rupturing. Sometimes it takes several passes to achieve a satisfactory result. The cardiologist may also inflate a balloon to smooth the results. After the procedure is complete, the guiding catheter and atherectomy devices are removed from the groin.
Once in position, the cardiologist inflates a balloon that presses a small metal window against the blockage in the artery. A cutting device released through this window shaves off the blocking tissue. When the procedure is complete, normal blood flow is reestablished to the previously blocked artery.
The expandable walls of the artery can withstand the pressure of balloon inflation and tissue shaving without rupturing. Sometimes it takes several passes to achieve a satisfactory result. The cardiologist may also inflate a balloon to smooth the results. After the procedure is complete, the guiding catheter and atherectomy devices are removed from the groin.
