Atherectomy

June 1, 2023

Atherectomy is a minimally invasive procedure used to treat narrowed or blocked arteries by removing plaque buildup.

Atherectomy is performed to treat conditions such as peripheral artery disease (PAD) or coronary artery disease (CAD) where plaque buildup narrows the arteries and restricts blood flow. The procedure involves the use of a catheter with a cutting or ablating device to remove or modify the plaque, restoring blood flow and improving symptoms.

 

Treatment

Atherectomy is used to treat arterial blockages caused by plaque buildup. It is commonly performed in the peripheral arteries of the legs or the coronary arteries of the heart. The specific treatment goals vary depending on the location and severity of the blockage. Atherectomy can help relieve symptoms such as leg pain, improve walking distance, and reduce the risk of complications associated with reduced blood flow.

 

Before the Procedure

Before the atherectomy procedure, your physician will evaluate your medical history, perform a physical examination, and conduct relevant diagnostic tests such as angiography or imaging studies. You may be advised to stop certain medications before the procedure and will be given instructions regarding fasting or dietary restrictions.

 

During the Procedure

The atherectomy procedure generally involves the following steps:

  • Anesthesia: Local anesthesia is administered to numb the area where the catheter will be inserted. In some cases, mild sedation may be used to help you relax.
  • Catheter insertion: A catheter is inserted through a small incision, usually in the groin or arm, and guided through the blood vessels to reach the site of the blockage.
  • Plaque removal: The atherectomy device, such as a rotating blade, laser, or drill, is advanced through the catheter and used to remove or modify the plaque. The specific technique depends on the type of atherectomy device used.
  • Debris removal: As the plaque is removed, the debris is collected or flushed out of the artery.
  • Catheter removal: After the procedure is complete, the catheter is carefully removed, and pressure is applied to the incision site to prevent bleeding.

 

After the Procedure

After atherectomy, you will be closely monitored in a recovery area for a period of time, typically a few hours. Vital signs, including blood pressure and heart rate, will be checked regularly. Your physician may prescribe medications to prevent blood clots, lower cholesterol, or manage other underlying conditions. You will receive instructions for post-procedure care, including wound care, physical activity restrictions, and follow-up appointments.

 

Advantages of Atherectomy

  • Precise plaque removal: Atherectomy allows for precise removal or modification of plaque, resulting in improved blood flow and reduced risk of complications.
  • Minimally invasive: Atherectomy is a minimally invasive procedure that requires small incisions, shorter hospital stays, faster recovery time, and lower risk of complications compared to open surgery.
  • Suitable for certain types of plaque: Atherectomy can be effective for treating specific types of plaque, such as calcified or fibrous plaque, which may be more challenging to treat with other techniques like balloon angioplasty.

 

Risks and Complications

While atherectomy is generally considered safe, there are potential risks and complications associated with the procedure. These may include:

  • Bleeding or hematoma at the insertion site
  • Infection
  • Blood vessel damage or dissection
  • Blood clots forming at the treated site
  • Allergic reactions to contrast dye
  • Irregular heart rhythms
  • Artery narrowing or closure

 

Typical Recovery Time

The recovery time after atherectomy can vary depending on individual factors, the extent of the procedure, and the location of the treated artery. In general, most individuals can expect to stay in the hospital for a day or two. Full recovery may take a few days to a week, during which time you may be advised to limit physical activities and follow any prescribed medications or lifestyle modifications.

 

Results and Post-Procedure Care

Following atherectomy, many individuals experience improved blood flow, reduced symptoms, and increased exercise tolerance. It’s important to adhere to post-procedure care instructions provided by your healthcare team, which may include:

  • Taking prescribed medications, such as antiplatelet drugs or cholesterol-lowering medications.
  • Following a heart-healthy diet and maintaining a healthy lifestyle, including regular exercise and smoking cessation.
  • Attending follow-up appointments with your healthcare provider for monitoring and necessary tests, such as imaging studies or angiography, to evaluate the treated artery’s condition.

 

The information provided is for educational purposes only. If you have specific concerns about a procedure or your health, please consult a physician.