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Atherectomy

The heart is a beating muscle that continually pumps blood to the rest of the body. The coronary arteries supply the heart itself with the necessary oxygen and nutrients it needs to function effectively.

Over time, and for a variety of reasons, fatty deposits called plaque can build up inside the arteries, clogging the passages and reducing their size. This buildup compromises the ability of the arteries to deliver oxygen and nutrients to the heart and body. Atherectomy is the general term for the group of procedures that open the clogged arteries by grinding or cutting away plaque buildup.

During an atherectomy procedure, an incision is made into the femoral artery of the upper thigh. A guidewire is inserted into the artery and is threaded through the artery to the site of the blockage. A catheter tipped with a specialized blade is inserted along the guide wire. There are three main variations of an atherectomy procedure, each using a specific type of catheter tip.

Rotational atherectomy, also called rotablator, is a common type of atherectomy. With this procedure, the catheter is tipped with a diamond burr that is guided to the blockage. While the burr spins at a very high speed, it grinds the hardened plaque into minute particles that can be safely eliminated by the body's own systems.

Directional atherectomy is designed to remove buildup of softer plaque. After catheter insertion, a balloon is inflated along the catheter that pushes the blade toward the plaque. The blade cuts away at the plaque and stores it in a special chamber. The balloon is then deflated and the plaque is removed with the chamber as the catheter is withdrawn.

Transluminal extraction is a vacuum device that not only uses spinning blades to cut away plaque, it also uses a tube which suctions the plaque through a vacuum that is attached to the catheter.