Atherectomy

Atherectomy refers to a surgical technique that is used in the treatment of atherosclerosis of the artery. Atherosclerosis is a condition of the arteries wherein the walls of an artery thicken and narrow due to accumulation of white blood cells resulting in a plaque build-up. Atherectomy is done by inserting a specialized catheter with a sharp blade in the blocked artery which removes the plaque build up from the blood vessels and also collects it. It can be used in the treatment of coronary heart disease or peripheral heart disease, as an alternative to, or as a complement to angioplasty.

Know More About Surgery

Atherosclerosis can affect coronary arteries, carotid arteries and peripheral arteries. Depending on the location of the blockage, the following symptoms may be seen:-

  • Coronary arteries- are those that provide blood to the heart. Symptoms like chest pain, weakness, coughing, dizziness, palpitations and anxiety can indicate a blockage in the coronary arteries.
  • Carotid arteries- carotid arteries supply blood to the brain and a blockage can cause a stroke. Other symptoms may include headaches, facial numbness, troubles with speech, paralysis, loss of balance, problems with coordination, confusion and dizziness.
  • Peripheral arteries- are arteries that supply blood to the limbs. Some of the symptoms include weakness and numbness in the legs, hair loss on legs, erectile dysfunction in men, slower hair and toenail growth on the legs and painful cramps.

Atherosclerosis can be diagnosed with the help of the following tests:-

  • Physical exam- during the physical exam, the doctor might look for weak pulse, an aneurysm and low blood pressure. Slow wound healing due to restricted blood flow can also be a sign of blockage. The doctor may also listen to the heart through a stethoscope. A ‘whooshing’ sound indicated blockage in the artery.
  • Ultrasound- would show the presence of a blockage
  • CT scan- a CT scan would help in determining the arteries that have narrowed
  • Electrocardiogram (EKG)- an EKG measures the electrical activity in the heart. It would help in looking for restricted blood flow
  • Magnetic resonance angiography- would help in seeing the large arteries in the body

The skin of the patient is numbed from where the catheter is supposed to be introduced. The catheter may be inserted through the arm or the groin depending upon the location of the artery that is blocked. A dye or contrast material may be injected into the artery and the blockage is determined with the help of X-rays. The catheter may have a cutting device, a grinding device or a laser filament which is used to remove the plaque. The plaque is then collected or suctioned out through the catheter. The doctor may also insert a stent once the artery is opened up to keep it open and the catheter is then removed.

An atherectomy may have the following complications:

  • Excessive bleeding
  • Allergic reaction to the contrast material used.
  • Risk of damage to the artery
  • Risk of a stroke
  • Risk of a possible infection at the site where the catheter was inserted

The patient may be required to stay in the hospital for 1-2 days. They can resume normal activities in a couple days once home. The procedure may have to be repeated if the blockage reoccurs, which would be 3-6 months after the procedure. The patient can take care of himself by refraining from activities like smoking and following a healthy diet and exercise plan. 

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Atherectomy

Atherectomy refers to a surgical technique that is used in the treatment of atherosclerosis of the artery. Atherosclerosis is a condition of the arteries wherein the walls of an artery thicken and narrow due to accumulation of white blood cells resulting in a plaque build-up. Atherectomy is done by inserting a specialized catheter with a sharp blade in the blocked artery which removes the plaque build up from the blood vessels and also collects it. It can be used in the treatment of coronary heart disease or peripheral heart disease, as an alternative to, or as a complement to angioplasty.

Symptoms

Atherosclerosis can affect coronary arteries, carotid arteries and peripheral arteries. Depending on the location of the blockage, the following symptoms may be seen:-

  • Coronary arteries- are those that provide blood to the heart. Symptoms like chest pain, weakness, coughing, dizziness, palpitations and anxiety can indicate a blockage in the coronary arteries.
  • Carotid arteries- carotid arteries supply blood to the brain and a blockage can cause a stroke. Other symptoms may include headaches, facial numbness, troubles with speech, paralysis, loss of balance, problems with coordination, confusion and dizziness.
  • Peripheral arteries- are arteries that supply blood to the limbs. Some of the symptoms include weakness and numbness in the legs, hair loss on legs, erectile dysfunction in men, slower hair and toenail growth on the legs and painful cramps.

Diagnosis

Atherosclerosis can be diagnosed with the help of the following tests:-

  • Physical exam- during the physical exam, the doctor might look for weak pulse, an aneurysm and low blood pressure. Slow wound healing due to restricted blood flow can also be a sign of blockage. The doctor may also listen to the heart through a stethoscope. A ‘whooshing’ sound indicated blockage in the artery.
  • Ultrasound- would show the presence of a blockage
  • CT scan- a CT scan would help in determining the arteries that have narrowed
  • Electrocardiogram (EKG)- an EKG measures the electrical activity in the heart. It would help in looking for restricted blood flow
  • Magnetic resonance angiography- would help in seeing the large arteries in the body

Treatment

The skin of the patient is numbed from where the catheter is supposed to be introduced. The catheter may be inserted through the arm or the groin depending upon the location of the artery that is blocked. A dye or contrast material may be injected into the artery and the blockage is determined with the help of X-rays. The catheter may have a cutting device, a grinding device or a laser filament which is used to remove the plaque. The plaque is then collected or suctioned out through the catheter. The doctor may also insert a stent once the artery is opened up to keep it open and the catheter is then removed.

Risks

An atherectomy may have the following complications:

  • Excessive bleeding
  • Allergic reaction to the contrast material used.
  • Risk of damage to the artery
  • Risk of a stroke
  • Risk of a possible infection at the site where the catheter was inserted

After Procedure

The patient may be required to stay in the hospital for 1-2 days. They can resume normal activities in a couple days once home. The procedure may have to be repeated if the blockage reoccurs, which would be 3-6 months after the procedure. The patient can take care of himself by refraining from activities like smoking and following a healthy diet and exercise plan.