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Atherectomy for Coronary Artery Disease


Treatment Overview

Atherectomy involves techniques similar to those used for angioplasty. The difference is that atherectomyClick here to see an illustration. uses special tools to remove the plaque buildup from the artery wall.

Atherectomy is not done for most people who have angioplasty. But in certain cases, it might help your doctor open up a narrowed artery.

What To Expect After Treatment

After an atherectomy, you will be moved to a recovery room or to the coronary care unit. Your heart rate, pulse, and blood pressure will be closely monitored, and the catheter insertion site will be checked for bleeding. To prevent bleeding, you may have a large bandage or a compression device on the catheter insertion site. You will be instructed to keep your leg straight if the insertion site is in your groin area.

You most likely will start walking within 12 to 24 hours after an atherectomy. The average hospital stay is 1 to 2 days for uncomplicated procedures. After several days, you may resume exercise and driving.

After atherectomy you will most likely take medicine, such as aspirin and another antiplatelet such as clopidogrel, to help prevent the formation of blood clots.

After your procedure, you might attend a cardiac rehabilitation program. In cardiac rehab, a team of health professionals provides education and support to help you recover and make new, healthy habits, such as eating right and getting more exercise. Making these changes is just as important as getting treatment in keeping your heart healthy and your arteries open.

Why It Is Done

Atherectomy is a procedure used to open up narrowed coronary arteries to increase blood flow. It might be done if an artery has hard plaque with a lot of calcium. Atherectomy may make it easier for your doctor to place a stent in the artery.1

How Well It Works

Atherectomy can work as well as angioplasty to widen narrowed arteries. Atherectomy might be done along with stenting. This can help keep the artery from narrowing again.2

Risks

Risks of atherectomy may include:

  • Heart attack during the procedure (small percentage).
  • Closing off of the artery, which requires emergency bypass surgery.
  • Bleeding.
  • Heart rhythm problems.

Another risk is that small pieces of plaque that are cut off during atherectomy can lodge in smaller arteries and damage heart tissue. Some devices can filter or capture these small pieces and remove them from the blood.

The risk for complications during atherectomy can be reduced if it is done by a cardiologist who is experienced with the procedure.

What To Think About

Talk to your doctor if you are worried about the risks of having atherectomy.

Complete the special treatment information form (PDF)Click here to view a form.(What is a PDF document?) to help you understand this treatment.

References

Citations

  1. Levine GN, et al. (2011). 2011 ACC/AHA/SCAI guideline for percutaneous coronary intervention: A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. Circulation, 124(23): e574–e651.

  2. Douglas JS, King SB (2011). Percutaneous coronary intervention. In V Fuster et al., eds., Hurst's The Heart, 13th ed., vol. 2, pp. 1430–1457. New York: McGraw-Hill.

Credits

ByHealthwise Staff
Primary Medical ReviewerRakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
Specialist Medical ReviewerRobert A. Kloner, MD, PhD - Cardiology
Last RevisedApril 5, 2012

eMedicineHealth Medical Reference from Healthwise

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