"Crackers, breakers, stretchers, drillers, scrapers, shavers, burners, welders and melters"--the future treatment of atherosclerotic coronary artery disease? A clinical-morphologic assessment.

Although various public health preventive efforts and prescribed pharmacologic treatment methods will have long-term benefits in the reduction of coronary artery atherosclerosis and subsequent cardiac events, the immediate and short-term future in the treatment of coronary artery disease will focus on several interventional devices designed to remodel or remove causes of acute and chronic coronary artery obstruction. Certain clinical-morphologic aspects of these interventional devices or techniques that result in remodeling of the coronary lumen shape (balloon angioplasty, thermal probes, intravascular stents) or removal of obstructing material (lasers, atherectomy devices) are reviewed. Two new areas in the pathology of atherosclerotic plaque (plaque fissures, eccentric plaque) and their clinical relevance in coronary heart disease are described.