Atherectomy: When is it needed? Procedure

The heart is a beating muscle that continuously pumps blood to the rest of the body. The coronary artery supplies the heart itself with the necessary oxygen and nutrients it needs to function effectively. Over time because of a variety of reasons, fatty deposits called plaque can build up inside the arteries clogging passages and reducing their size. This build-up comprises the ability of the artery to deliver oxygen and nutrients to the heart and body. Atherectomy is the general term for the group of procedures that opens the clogged arteries by grinding or cutting away plaque build-up.

When is Atherectomy required?

The goal of Atherectomy is to open a pathway through the blocked artery and to improve the blood flow through a small hole.

It is indicated in patients who have clogged blood vessels that prevent the supply of oxygen and nutrients to the muscles causing tiring of the muscles.

• Atherectomy is especially suited in cases where there is blockage of arteries around branches or in arteries where it is very difficult or impossible to send stent.

Although being less invasive, it is not indicated for everyone.

• Atherectomy is indicated in cases where there is a previous history of failed balloon angioplasty.
• In cases where calcium deposits are blocking the arteries

How is Atherectomy done and its types?

An atherectomy is a group of procedures that includes grinding or cutting away the plague. In this procedure, an incision is made into the femoral artery. During the surgery, a guidewire is inserted into the artery and is threaded through the artery to the site of the blockage. A catheter tipped with a special blade is inserted along the guidewire.

There are three main variations of the Atherectomy procedure with a particular type of tip. These are:

• Rotational Atherectomy: In this procedure, the catheter is tipped with a diamond bur. This bur rotates at a very high speed grinding the plague into minute particles that can be safely eliminated by the body.
• Directional Atherectomy: This procedure is primarily for soft plaque. In this procedure, when the catheter reaches the point of blockage, a balloon is inflated against the catheter pushing the blade towards the plague. The blade cuts away the plaque and stores it in the special chamber. The balloon is then deflated, and the plague is taken out with the catheter as it is withdrawn out.
• Transluminal extraction: It is a vacuum device that not only uses a spinning blade to cut away the plague, it also uses a tube which suctions the plague through the vacuum that is attached to the catheter.

Pre-operative care:

Before the surgery, your doctor will advise you on some tests to ascertain your medical condition before he proceeds with the operation. There are few medicines that will be prescribed to discontinue until the surgery is done.

How long does the surgery last?

The surgery lasts for around 90 minutes to 180 minutes. After the surgery, the patient is asked to lie flat for 4-7 hours. The patient is expected to be admitted one day before the surgery to check the patient’s present medical condition and is usually discharged after one day to rule out postoperative complications.

Postoperative care:

It takes around 1-2 weeks to recover after the surgery.

• Precautions must be taken as advised by the doctor.
• Avoid stress
• Avoid smoking
• Avoid public places to reduce the chances of getting infected
• Take medicines as directed by your doctor.

When to see a doctor?

If you experience the following symptoms:

• Arrhythmia
• Pain in chest
• Pain
• Hemorrhage
• Drug reactions /allergy

Top Cardiologists/Cardiac Surgeons in India

See more