Atherectomy�is a procedure used to remove plaque�cholesterol and fibrous tissue that blocks arteries. During an atherectomy, a clogged artery is cleared by cutting, shaving or vaporizing the plaque that is blocking a blood vessel. The device called a catheter is used to perform an atherectomy.
Atherectomy treats diseased coronary arteries, but is used far less commonly in arteries outside the heart.
Today most atherectomy procedures are performed in the coronary arteries. Atherectomy in peripheral arteries like those in other parts of the body such as the legs are done rarely.
The site where the catheters are inserted (usually above the femoral artery in the groin) is cleaned and shaved and is numbed with a local anesthetic. The physician then makes a tiny incision in the skin and inserts a guide wire and then a catheter sheath over the wire. Catheters may be withdrawn and inserted through the sheath during the procedure.
Based on an arteriogram, the physician chooses the appropriate device to perform the atherectomy. There are two main categories of atherectomy devices�those that shave or cut plaques, and those that pulverize plaques. Once the physician has selected the appropriate device, he or she advances it through the arteries to the plaque.
In Rotational atherectomy uses a tiny rotating cutting blade to open a narrowed artery and improve blood flow to or from the heart. Often a stent�a small tube made of metal mesh�is put in the artery to prevent it from re-narrowing. Rotational atherectomy is the most common atherectomy procedure and is used to treat complex lesions and in-stent restenosis.
The indications for directional atherectomy are more limited and the use of directional atherectomy has mostly fallen out of favor. Some of the possible indications of directional atherectomy include:
