What is an Atherectomy?

Atherectomy is a medical treatment from atherosclerosis or narrowing of the arteries that may be appropriate in some cases. It is often looked as a good first option because it falls under the category of what are considered minimally invasive procedures. This means the procedure does not involve any form of open surgery and is likely to be tolerated well by a broader patient range.

A simple description of how atherectomy is performed includes that this is a procedure via catheterization. Most often in the groin, a catheter or thin tube is inserted into the blood vessel and threaded through it until the area of narrowing is reached. There is a small razor-like device or burr that is attached to the catheter, and this is used to remove or “shave” the plaque from within the artery. Once this matter is detached, the catheter is removed too, and the procedure frequently results in widening the blood vessel that is blocked, restoring greater blood flow.

Patients experiencing atherectomy are not anesthetized during the procedure. They may be awake or under what is called twilight sleep sedation. Most people are unable to feel any activity within the arteries, but they may feel a small amount of pressure where the catheter is inserted. To minimize this, local anesthesia is used to create little sensation in that area. The one complaint some patients may express about atherectomy is the sound of the procedure, which has been compared to the sound of a dentist’s drill.

On the other hand, recovery time after atherectomy tends to be minimal. To make sure no excess bleeding occurs, patients must remain in a flat position for a number of hours. Usually they can expect an overnight stay in the hospital, but many people go home the day after, provided there are no complications. Though complications are rare, they can exist, and they include the atherectomy reversing itself or passage of blood clots or matter into other areas of the body, creating different kinds of stroke.

To minimize self-reversal of the procedure, doctors may consider placing a stent after the shaving process. This isn’t always possible. Sometimes the narrowed area is too small for stent placement. In fact, one of the reasons atherectomy is performed is due to narrowing in a very small area that won’t support a stent of any size. Given adequate size, though, stent placement might be considered if it is deemed necessary.

When a person has this treatment, due consideration of why plaque build-up occurred, is necessary. People are encouraged to pursue lifestyles or make changes that are consistent with avoiding atherosclerosis in the future. For instance, smokers have a much higher risk of sudden atherectomy reversal. Smoking cessation and changes in diet and exercise are urged. Discovery of narrowed arteries might also suggest treatment with medication/s to help improve cardiac health, keep plaque accumulation in the arteries low, and prevent stroke.