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. THANK YOU