Atherectomy

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Blausen Atherectomy eng

Atherectomy is a medical procedure used to remove atherosclerosis from blood vessels within the body. Atherosclerosis is a condition where plaque builds up on the walls of arteries, causing them to narrow and restrict blood flow. Atherectomy is particularly useful in treating peripheral artery disease (PAD), which commonly affects the legs, but it can also be used in other arteries. The procedure is minimally invasive and aims to restore blood flow by removing or cutting away the plaque from the arterial walls.

Types of Atherectomy[edit | edit source]

There are several types of atherectomy procedures, each using different methods to remove the plaque. These include:

  • Directional Atherectomy: Involves a catheter with a cutting blade on the side that shaves off plaque as it is guided through the artery.
  • Rotational Atherectomy: Uses a diamond-coated burr that spins at high speeds to grind away plaque.
  • Orbital Atherectomy: Similar to rotational atherectomy but uses an orbiting tool to sand away plaque more effectively in harder or calcified lesions.
  • Laser Atherectomy: Employs a laser to vaporize or ablate the plaque.

Procedure[edit | edit source]

The atherectomy procedure typically involves the following steps:

1. The patient is given a local anesthetic to numb the insertion site, usually in the groin. 2. A guide wire is inserted into the artery, followed by a catheter that carries the atherectomy device. 3. The device is advanced to the site of the blockage under imaging guidance. 4. The plaque is removed or modified using the device, and the debris is collected to prevent it from traveling through the bloodstream. 5. The device and catheter are removed, and the insertion site is closed.

Risks and Complications[edit | edit source]

As with any medical procedure, atherectomy carries certain risks and complications, including:

  • Bleeding at the catheter insertion site
  • Damage to the blood vessel
  • Embolization, where debris from the plaque can block other arteries
  • Restenosis, where the artery narrows again after the procedure

Recovery[edit | edit source]

Recovery from an atherectomy procedure is typically quicker than from traditional open surgery. Patients may be required to stay in the hospital for a short period for monitoring but can usually resume normal activities within a few days. Medications may be prescribed to prevent blood clots and manage any discomfort.

Conclusion[edit | edit source]

Atherectomy offers a minimally invasive option for treating atherosclerosis and restoring blood flow in affected arteries. With various techniques available, the choice of atherectomy method depends on the location and characteristics of the arterial plaque. While the procedure is generally safe, it is important for patients to discuss the potential risks and benefits with their healthcare provider.

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Contributors: Prab R. Tumpati, MD