Tests & Procedures > Interventional Cardiology > Percutaneous Atherectomy

Percutaneous Atherectomy

Our vascular surgeons have extensive experience performing percutaneous atherectomy for the treatment of peripheral vascular disease.

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During percutaneous atherectomy, the blocked area inside your artery is "shaved" away by a tiny device on the end of a catheter. The procedure is done through a small incision in your groin using catheters threaded through the artery.

What is Atherectomy?

As you age, can build up along the walls of your arteries causing your arteries to narrow and stiffen. If enough plaque builds up it can reduce reduce blood flow or cause irregularities in the normally smooth inner walls of the arteries.

An atherectomy is a procedure in which your vascular surgeon inserts a specialized catheter into a blocked artery to remove a buildup of plaque from within the artery. The catheter contains a sharp rotating blade, grinding bit, or laser filament, as well as a collection system that permits your surgeon to remove the plaque from the wall of the vessel and collect or suction any resulting debris.

Atherectomy can be used to treat blockages where angioplasty and stenting cannot be performed. it can also be used as a complement to angioplasty and stenting, removing blockages to allow for the insertion of a balloon and stent.

Who should consider atherectomy?

A good candidate for an atherectomy may be a patient who:
  • has severe narrowing of peripheral arteries that cannot be easily treated with angioplasty and stenting
  • cannot have a bypass surgery
  • has a blockage indicates that atherectomy should be used as a preliminary step to angioplasty and stenting.

How to Prepare for Atherectomy

Your doctor will explain the procedure to you and offer you the opportunity to ask any questions that you might have about the procedure.
  • You will need to fast prior to the procedure. Your doctor will notify you how long to fast, usually overnight.
  • Notify your doctor of all medications (prescription, over-the-counter or herbal supplements) you are taking; if you are pregnant or suspect that you may be pregnant; if you are allergic to or sensitive to medications, local anesthesia, or latex; if you have kidney failure or other kidney problems or if you are allergic to or sensitive to contrast dye or iodine.
  • Plan for your care and transportation after the procedure and during recovery at home.

What happens during the Atherectomy?

You will be given a local anesthetic to numb the area where the catheter will be inserted. You will stay awake during the procedure, but be sedated for comfort.

Your surgeon will thread a thin guide wire into the blocked artery through a needle inserted into a blood vessel in your groin. Dye is injected into the artery and X-rays are taken while the dye moves through your artery. Using these x-ray images, an atherectomy catheter will be advanced to the location of the blockage. The catheter is a thin tube inserted into a blood vessel in your groin and contains a cutting blade, grinding device, or laser filament, that will be used to remove the blockage. In addition, the catheter also contains a collection or suctioning system used to remove any debris as a result of the procedure.

Once the blocked portion of the vessel opens and blood flow is improved, your surgeon may place a metal device called a stent at the location of the blockage to reduce the likelihood of another blockage from forming. The catheter is then removed.

What happens after the procedure?

You will go back to your hospital room and rest in bed for 12 to 24 hours. You will most likely be able to go home the next day. You can usually resume normal activity within a day or two.

What are the risks?

  • You may have an allergic reaction to the local anesthetic or x-ray dye.
  • You may bleed a lot and need medicine or a blood transfusion.
  • The artery may be damaged. For example, the artery might be perforated during the procedure. Emergency bypass surgery or repair of the perforation (hole) would then be needed.
  • There is a risk of injury to the groin where the catheter was inserted.
  • The blockage may come back after 3 to 6 months.