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00:00DCA, or Directional Coronary Atherectomy, is a minimally invasive procedure to remove
00:07blockage from coronary arteries to improve blood flow to the heart muscle and ease pain.
00:17First, a local anesthesia numbs the groin area.
00:22Then the doctor puts a needle into the femoral artery, the artery that runs down the leg.
00:27The doctor inserts a guide wire through the needle, and then removes the needle.
00:38He replaces it with an introducer, a tubular instrument with two ports used to insert flexible devices, such as a catheter, into a blood vessel.
00:49Once the introducer is in place, the original guide wire is replaced by a finer wire.
00:54This new wire is used to insert a diagnostic catheter, a long, flexible tube, into the artery and guide it to the heart.
01:04The doctor then removes the second wire.
01:15With the catheter at the opening of one of the coronary arteries, the doctor injects dye and takes an x-ray.
01:23If it shows a treatable blockage, the doctor uses another guide wire to remove the first catheter and replace it with a guiding catheter.
01:38Then the wire that was used to do this is removed and replaced by a finer wire that is advanced across the blockage.
01:53Another catheter, designed for lesion cutting, is also advanced across the blockage site.
01:59A low-pressure balloon attached next to the cutter is inflated, exposing lesion material to the cutter.
02:07A drive unit is turned on, causing the cutter to spin.
02:11The doctor advances a lever on the drive unit that in turn advances the cutter.
02:16The pieces of blockage it cuts away are stored in a section of the catheter called a nose cone, until they are removed at the end of the procedure.
02:31Rotating the catheter, while inflating and deflating the balloon, makes it possible to cut the blockage in any direction, leading to uniform debulking.
02:41A stent may also be placed.
02:44This is a latticed metal scaffold put inside the coronary artery to keep the vessel open.
02:51After the procedure, the doctor injects dye and takes an x-ray to check for change in the arteries.
03:00Then the catheter is removed and the procedure is over.