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Atherectomy / Plaque Excision

Atherectomy, also called plaque excision, is a new procedure to reopen blocked arteries in the legs. Harmful fatty build-up (plaque) can block normal blood flow to the legs. This can result in pain in the legs when walking, sores that won’t heal, and in some cases amputation.

What Happens During The Procedure?

On the day of the procedure, patients are given medication to relax which poses less risk than general anesthesia. Local anesthesia is used in the groin region to numb the area where a very small cut is made. A tiny flexible tube called a catheter is inserted into an artery in the groin region and threaded down the artery to the point of blockage. X-ray technology allows the doctor to view the artery on a computer screen as he re-opens the blockage.

A device on the end of the catheter houses a tiny rotating blade about the size of a grain of rice. The blade shaves the plaque from the walls of the artery as it moves past the blockage. The catheter collects the plaque as it is shaved away. When the catheter is removed, the shaved plaque is completely removed from the patient’s body. Blood flow through the artery is restored.

The atherectomy procedure can take anywhere from half an hour to several hours, depending on the amount of blockage.

What Happens After The Procedure?

Atherectomy patients are usually monitored overnight and go home the next morning. The procedure should get rid of leg pain caused by formerly blocked arteries as blood flow is restored to the leg. Patients who have an atherectomy are less likely to need the procedure again if they continue taking cholesterol lowering medication. They should also eat a healthy diet, exercise, closely monitor diabetes, monitor and control hypertension (high blood pressure), and stop smoking.

What Are The Risks/Limitations of Artherectomy?

Atherectomy is a new procedure and has proved to be a safer alternative than a surgical bypass procedure to improve or restore blood flow. Surgical bypass requires a much larger incision and is done under general anesthesia. However, some patients are not candidates for an atherectomy and may be referred to a surgeon for a bypass procedure. Although small, there is still a risk of developing another blockage following a plaque excision.

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