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 suction thru the 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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