Atherectomy
Submitted to :Sir Rouman
Submitted by : Shireen Sajjad BS RIT-19
01
Introduction
02
Ty p e s o f A t h e r e c t o m y
03
Procedure and indications
04
Risks and Complications
CONTENTS
01
Introduction
01
I ntroduc ti on to Athe re c tomy :
Introduction:
Ather ectomy
i s
a
minimally invasive medical
procedure used to treat
atherosclerosis,
a
condition characterized by
the buildup of plaque
inside the arteries.
Atherectomy
Atherectomy
Atherectomy
Atherectomy
This buildup can lead to
It is an alternative to
It
b a l l o o n
Atherectomy aims to
reduced blood flow
traditional treatments.
angioplasty and stent
remove or modify the
placement.
plaque.
replace
02
Types of Atherectomy
02
Ty pe s of Athe re c tomy
Types of Atherectomy:
Directional Atherectomy:
In this technique, a catheter with a rotating blade or cutter at its tip is inserted into the
affected artery. The rotating blade shaves off and removes the plaque from the arterial walls.
Rotational Atherectomy:
This procedure utilizes a high-speed, diamond-tipped burr at the end of a catheter. The
burr rotates and abrades the plaque, essentially grinding it into smaller particles that can be carried away by the
bloodstream or removed later.
02
Ty pe s of Athe re c tomy
Orbital Atherectomy:
Laser Atherectomy:
•
•
It involves using a small, diamond-coated
crown attached to the tip of a catheter.
•
The crown orbits eccentrically within the
This method employs laser energy to
vaporize or break down the plaque.
•
The las er catheter emits i ntens e light,
a r ter y, s a n d i ng away t h e p l a q u e i n a
which targets and disintegrates the
controlled manner.
plaque material.
03
Procedure and Indication
Procedure
03
Procedure:
•
01
Access Site:
02
Guidewire Placement:
03
Atherectomy Catheter Insertion:
03
Plaque Removal or Modification:
The atherectomy procedure typically takes
place in a specialized cardiac
catheterization laboratory (cath lab) or an
interventional radiology suite.
•
•
The patient is usually under local
anesthesia, and in some cases, conscious
sedation may be used to keep the patient
relaxed.
Procedure
03
Procedure:
•
05
Debris Removal:
06
Completion and Potential Stent Placement:
07
Recovery and Follow-up:
The atherectomy procedure typically takes
place in a specialized cardiac
catheterization laboratory (cath lab) or an
interventional radiology suite.
•
•
The patient is usually under local
anesthesia, and in some cases, conscious
sedation may be used to keep the patient
relaxed.
03
Procedure
01
Access Site:
The physician gains access to the affected artery, usually in the leg (femoral
artery) or arm (radial artery), by making a small incision and inserting a
sheath.
02
Guidewire Placement:
A guidewire is threaded through the sheath and advanced to the location of
the arterial blockage.
This guidewire acts as a guide for the atherectomy catheter.
03
Procedure
03
Atherectomy Catheter Insertion:
The atherectomy catheter, specific to the chosen procedure type (e.g.,
rotational, directional, orbital, or laser), is advanced over the guidewire to
the site of the plaque buildup.
04
Plaque Removal or Modification:
T h e a t h e r e c to my d ev i c e i s a c t i va t e d , a n d d e p e n d i n g o n t h e t y p e o f
procedure, it removes or modifies the plaque within the artery.
03
Procedure
05
Debris Removal:
As the atherectomy device works, plaque particles or debris are generated.
These particles may be flushed out of the artery using saline or removed
with a suction device attached to the catheter.
06
Completion and Potential Stent Placement:
After the atherectomy is deemed complete, the physician may decide to
place a stent in the treated area to help keep the artery open. Stents act as
scaffolds, preventing the artery from narrowing again.
03
Procedure
Recovery and Follow-up:
07
•
Once the procedure is finished, the catheter and sheath are removed, and the access site
is typically sealed with a closure device or manual pressure.
•
Patients are usually observed for a short period in the recovery area before being
discharged. They may need to take medications, such as blood thinners, to prevent clot
formation post-procedure.
•
Follow-up visits with the physician are scheduled to monitor the patient's progress and
ensure the treated artery remains open.
03
Indications
Indications:
1. Atherectomy is indicated in cases of peripheral arterial disease (PAD), coronary artery disease
(CAD), and, less commonly, carotid artery disease.
2. It is often used when traditional balloon angioplasty may not be suitable due to severe or
calcified plaque, or when stent placement is not preferred.
3. Atherectomy can be particularly useful in treating complex and heavily calcified lesions that
pose challenges for other interventions.
4.
04
Risks and Complications
04
Risks and Complications
While atherectomy is generally considered safe and effective, like any medical procedure, it carries
certain risks, including:
Arterial Perforation:
In rare cases, the catheter can damage the arterial wall, causing a perforation.
Embolization:
The plaque material or debris can break loose during the procedure and travel downstream, potentially
causing blockages in smaller arteries.
Restenosis:
Despite the treatment, the artery may re-narrow over time, requiring additional interventions.
04
Risks and Complications
Vessel Dissection:
The catheter may cause a dissection (a tear) in the artery, necessitating further intervention.
Allergic Reactions:
Some patients may experience allergic reactions to the contrast dye used during the procedure.
Infection or Bleeding:
As with any invasive procedure, there is a risk of infection at the access site or excessive bleeding.
Summary
• Atherectomy is a valuable tool in the treatment of atherosclerosis, offering an alternative or
complementary approach to traditional treatments like balloon angioplasty and stent placement.
• The procedure is tailored to each patient's specific condition, and the choice of atherectomy type
depends on factors such as the location and severity of the plaque buildup.
• With ongoing advancements in technology and increased experience among medical practitioners,
atherectomy continues to play a significant role in improving outcomes for patients with arterial
disease.
• As with any medical procedure, patients should discuss the risks and benefits with their healthcare
provider to make informed decisions about their treatment options.
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