Atherectomy
Why is the doctor performing this procedure?
To remove plaque build-up (atherosclerosis) that is narrowing
or blocking one of the coronary (heart) arteries.
What is the procedure?
"Ather" refers to an atherosclerotic plaque within
a heart artery; "ectomy" means to cut it out. Atherectomy
is often part of a PTCA (angioplasty) procedure, but instead
of compressing the plaque into the artery wall, as is done
with balloon angioplasty, atherectomy actually cuts away and
removes fatty plaque to widen the artery and improve blood
flow. A catheter is inserted into an artery--usually in the
groin--but sometimes in the arm or wrist. The catheter is
advanced to the heart, and a series of x-ray pictures (coronary
angiogram) are taken to clearly visualize the heart artery
that is narrowed. Then a separate catheter with a cutting
device is advanced to the heart, and into the narrowed coronary
artery. Inside the artery, the cutting device cuts away at
the plaque, widening the artery so blood flow improves.
There are three different devices commonly used to perform
atherectomy:
- Directional Coronary Atherectomy
(DCA) uses a very small rotating blade within a balloon to
cut out the plaque and remove it safely from the blood
vessel.
- Rotational Atherectomy uses a
diamond-studded acorn-shaped drill to grind plaque down, and
is especially useful for calcified plaques.
- Extraction Atherectomy uses several tiny rotating blades
within a hollow tube to cut away the plaque, then uses vacuum
thru the hollow tube to remove the pieces from the vessel.
Balloon angioplasty and/or stent placement usually follows
atherectomy.
Where is the procedure performed?
In the Cardiac Catheterization Lab.
How long does this procedure take?
Atherectomy usually takes 1-3 hours.
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