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What Is an Atherectomy?

Medically Reviewed by James Beckerman, MD, FACC on October 26, 2021

An atherectomy is a minimally invasive procedure to remove plaque buildup from an artery (blood vessel). Removing this plaque allows blood to flow more freely through the artery.

An atherectomy often treats artery blockages that contain plaque — fatty substances made up of cholesterol, fats, calcium, and other substances. The procedure is also an alternative option if a blockage may not be easily treated with stents. 

Unlike an angioplasty, which moves plaque to the side of the artery, an atherectomy completely removes plaque from the artery. This helps bring a healthy flow of blood through the artery. A stent may be placed after plaque removal to help keep the artery open. Your doctor will evaluate your condition and provide you with an individualized treatment plan based on your circumstances.

Read on to learn what to expect from an atherectomy. 

When Is an Atherectomy Needed?

Doctors often recommend an atherectomy for  peripheral arterial disease (PAD) treatment and peripheral vascular disease treatment. This procedure is also typically done for people who have already had an angioplasty or recently had stents inserted to support a weak artery. 

What Happens During an Atherectomy?

Before the procedure, you'll receive a sedative to help you relax. A catheter is then inserted into your artery via your groin, upper thigh area, arm, or wrist. The catheter is guided through the blood vessel toward your heart. Your doctor will take a series of X-ray images to see the narrowed artery better.

Dye is injected through the catheter and into the coronary arteries to help your doctor pinpoint the affected area. Tiny blades or a laser are attached to the end of the catheter. These are used to remove the plaque. 

A stent procedure or angioplasty may be performed after the atherectomy to ensure that the artery stays open. Once complete, the catheter is removed. Typically, you'll be able to go home a day after the procedure.

What Should I Do After an Atherectomy?

After the procedure, you should inspect the site where the catheter was inserted, looking for signs of excessive bruising, swelling, or bleeding. Do this daily. Call your doctor if you see any significant changes or begin to feel an abnormal heart rhythm or notice any new tears around the incision. 

Your doctor may recommend that you avoid lifting anything heavier than 10 pounds or doing intense exercise like jogging or cycling for the week following the procedure. 

What Are the Risks of an Atherectomy?

As with any procedure, there are risks associated with an atherectomy, although they are rare. Your doctor will discuss whether you're at increased risk for complications and determine if the procedure is right for you. 

Some risks associated with an atherectomy include:

  • Embolization, which can happen when plaque that's been removed blocks another artery
  • Re-blockage of an artery (typically occurs in smokers)
  • X-ray exposure (which may cause cancer)
  • Allergy to the X-ray contrast dye
  • Impaired kidney function 

What Are the Benefits of an Atherectomy?

An atherectomy can improve your overall quality of life by relieving symptoms. People who struggle with blocked arteries often report experiencing symptoms of claudication (pain felt in the legs when walking) or leg fatigue.

An atherectomy provides quick relief, immediately restoring blood and oxygen flow to your heart muscle. After the procedure, you should have an easier time exercising and feel more energetic. 

Show Sources

SOURCES:

The American Journal of Cardiology: “Comparison of rotational atherectomy versus orbital atherectomy for the treatment of heavily calcified coronary plaques.”

Cleveland Clinic: "PAD: Atherectomy.”

The Journal of Cardiovascular Surgery: "The added benefits and efficacy of atherectomy in the lower limb."

The New England Journal of Medicine: “A Comparison of Directional Atherectomy with Coronary Angioplasty in Patients with Coronary Artery Disease.”

Stanford Healthcare: “Atherectomy.”

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