1. Helen Ng RDSC 326 Professor Gary Zimmerman
Atherectomy
Helen Ng
RDSC 326
Professor Gary Zimmerman

2. What is atherectomy?
Atherectomy is a procedure that mechanically removes plaque from the arterial wall.
It can be used to widen arteries that have closed or become blocked following a balloon angioplasty or treatment with sents.

3. Types of Atherectomy Directional Atherectomy Rotational Atherectomy
Transluminal Extraction Atherectomy

4. Directional Atherectomy
Designed to remove non-calcified plaque
Catheter tip has hollow end w/rotating blade
It has an open window on one side and a balloon on the other.
Balloon is inflated, pushing window against plaque.
Plaque protruding through window is shaved off by the rotating blade. The shavings are then caught in the chamber and removed

5. Directional Atherctomy catheter

6. Directional Athrectomy

7. Rotational Atherectomy
Most common type of atherectomy performed
Used for heavily calcifeid plaques and restenosis inside of stents
Rotational atherectomy blades are shaped like a football w/diamond coated tip. The blade spins at about 200,000rpm, and grinds away plaque into small fragments
The small fragments are then passed harmlessly through our circulatory system

8. Rotational Atherectomy catheter

9. Transluminal Extraction Atherectomy
Usually used for bypass graft arteries
Tiny rotating blade and a hollow tube
Particles are sucked into a tube through a vacuum

10. Preparation prior to procedure
Patient cannot eat or drink after midnight
Tests completed before admission to hospital
EKG
Chest x-ray
Blood test

11. Incision Sites Groin/Femoral Artery (most common) Arm/Brachial
Incision on the inside of upper thigh
Arm/Brachial
Incision on the inside of elbow
Transradial
Incision on inside of wrist

12. Postoperative Care
Patient is returned to recovery room and is monitored
Bed rest
Sheath is removed with six hours after procedure
When patient is discharged from hospital they should monitor the insertion site for bleeding, discoloration, and temperature change
Limit physical activity for 2 days
Follow up with doctor in 1-2 weeks after discharge
Follow up tread mill test performed to determine success of procedure

13. Effectiveness of Procedure
Atherectomy is 95% successful
30% of patients develop restenosis
Second atherectomy may be needed

14. Risk and Benefits Risks Heart attack Emergency bypass surgery
Coronary artery perforation
Benefits
Open blocked arteries
Improve blood flow to heart
Relieves symptoms
Improves exercise duration
Stops or prevent heart attacks