Atherectomy

An atherectomy is a minimally invasive medical procedure performed by vascular surgeons to remove plaque buildup from within blood vessels. This plaque accumulation, often due to atherosclerosis, can narrow or block arteries, impeding blood flow to vital organs and tissues.
Vascular surgeons perform atherectomies to address conditions such as peripheral artery disease (PAD) or coronary artery disease (CAD). These procedures are necessary when plaque buildup becomes significant enough to compromise blood flow, leading to symptoms such as pain, cramping, or even tissue damage.
During an atherectomy:
1. Guidewire Insertion: A thin, flexible guidewire is carefully inserted into the affected artery, guided by imaging techniques such as fluoroscopy or ultrasound.
2. Catheter Insertion: A special catheter equipped with cutting or ablating devices is then advanced over the guidewire to the site of plaque buildup.
3. Plaque Removal: Once the catheter is positioned within the narrowed artery, the surgeon activates the cutting or ablating device to remove or break up the plaque. Different types of atherectomy devices are available, including rotational, orbital, laser, or directional atherectomy, each tailored to specific plaque characteristics and vessel anatomy.
4. Debris Removal: As the plaque is removed, it may break into smaller particles or debris. Some atherectomy devices incorporate suction or aspiration capabilities to remove these particles from the bloodstream, reducing the risk of embolization or blockage in other blood vessels.
5. Post-Procedure Care: After plaque removal, the catheter and guidewire are carefully withdrawn, and the puncture site is typically sealed with a closure device or manual pressure. Patients may be monitored for a short period to ensure there are no complications.
Vascular surgeons perform atherectomies to improve blood flow, alleviate symptoms, and reduce the risk of complications associated with plaque buildup in arteries. These procedures are often used when plaque is particularly hard or calcified, making it less amenable to traditional treatments like angioplasty or stenting. By restoring blood flow to affected areas, atherectomies can help improve patients' quality of life and prevent serious complications such as limb ischemia or tissue loss.