Conditions & Procedures
What Is Atherectomy and When Is It Used?
Atherectomy is one of several endovascular tools used to treat peripheral artery disease (PAD), particularly when arteries are heavily calcified.
What is atherectomy?
Atherectomy uses a small catheter, advanced into the artery through a tiny puncture in the groin or arm, to remove or modify atherosclerotic plaque. By debulking calcified or fibrotic lesions, atherectomy can prepare the vessel for balloon angioplasty and improve the long-term performance of stents or drug-coated devices.
What types of atherectomy exist?
- Directional atherectomy: a blade shaves plaque in a controlled direction
- Rotational atherectomy: a high-speed burr abrades plaque
- Orbital atherectomy: an eccentric crown sands the vessel wall to modify calcium
- Laser atherectomy: pulsed ultraviolet light vaporizes plaque
When is atherectomy used?
Atherectomy is generally considered when:
- Lesions are heavily calcified
- Vessels are difficult to dilate with balloon angioplasty alone
- Lesions occur at flexion points, such as the popliteal artery
- Below-the-knee disease threatens limb viability
Where is atherectomy performed?
Atherectomy is performed in a hospital cardiac or vascular catheterization lab, or in an ambulatory surgery center (ASC). Amavita Research's affiliated ASC, Advanced Cardiovascular of Miami, is the only ASC of its kind in South Florida dedicated to interventional cardiovascular and vascular care.
What are the risks of atherectomy?
Risks include vessel perforation, dissection, distal embolization, access-site complications, and contrast-related kidney injury. The risk profile depends on technique, anatomy, and operator experience.
What is being studied in atherectomy research?
Active clinical research evaluates next-generation atherectomy systems, often in pivotal IDE trials registered on ClinicalTrials.gov. Amavita Research participates in pivotal peripheral atherectomy studies for calcified lower-extremity disease.
References
Frequently asked questions
What is atherectomy?
Atherectomy is a catheter-based procedure that removes or modifies plaque from inside an artery, often in the legs, to restore blood flow and prepare the vessel for additional therapy.
How is atherectomy different from angioplasty?
Angioplasty uses a balloon to push plaque outward, while atherectomy removes or modifies the plaque itself. The two are often used together, especially in calcified disease.
Where is atherectomy done?
Atherectomy is performed in a hospital catheterization lab or in an ambulatory surgery center such as Advanced Cardiovascular of Miami.
Is atherectomy painful?
Atherectomy is performed under local anesthesia with conscious sedation. Most patients describe pressure rather than pain at the access site.
How long is recovery after atherectomy?
Many patients go home the same day from an ASC. Activity is typically restricted for several days at the access site; your physician will give specific instructions.
Are there clinical trials for atherectomy?
Yes. Pivotal IDE trials evaluate new atherectomy systems for calcified PAD. Amavita Research participates in such studies.