Advanced Treatment to Remove Hardened Plaque 

Peripheral artery disease develops when you have a buildup of plaque in your arteries. This collection of cholesterol, fat and other substances is called atherosclerosis. Over time, it can cause blood vessels to become blocked or narrowed. Coronary atherectomy is a minimally invasive procedure used to treat these conditions.  

Coronary atherectomy uses tiny blades or lasers to grind and remove hardened plaque, improving your blood flow. It can also relieve symptoms of peripheral artery disease, including coldness in your legs, muscle pain, skin color changes and sores on your feet.  

Our interventional cardiologists rely on the most advanced minimally invasive tools and techniques to perform coronary artery disease treatment. Our goal is to help you avoid more complex procedures and get you back to the activities you enjoy most.  

Preparing for Coronary Atherectomy  

Before deciding if you need a coronary atherectomy, we need a clear picture of your heart and blood vessels. To see any blockages or narrow spots in your arteries, we may order: 

• Angiography: A minimally invasive, X-ray-guided procedure that uses a thin, flexible tube (catheter) and contrast dye to reveal blockages or narrow spots in your arteries  
• Vascular ultrasound: A radiation-free imaging test that uses sound waves to evaluate your blood flow and the health of your arteries 

If these tests show that you need a coronary atherectomy, we will schedule your procedure. We will also provide instructions about taking medications and eating or drinking before you arrive at the hospital. For some patients, coronary atherectomy is an outpatient procedure. Depending on your condition and any complications, we may need to keep you overnight for monitoring. 

What to Expect During Coronary Atherectomy 

We perform coronary atherectomy procedures in the cardiac catheterization lab. On the day of your procedure, we will place an IV in your arm or hand to deliver medication to help you relax. We will also provide local anesthesia to prevent pain.  

For the procedure, your interventional cardiologist will make a small cut (incision) in your artery. Using real-time X-ray guidance and a catheter, we thread a blade or laser to the plaque blocking or narrowing your blood vessel. To remove the plaque, we will use one of these approaches: 

• Excisional atherectomy: The blade will cut plaque in one direction. 
• Laser ablation atherectomy: A laser will break apart and destroy the plaque. 
• Orbital atherectomy: A spinning tool grinds the plaque away. 
• Rotational atherectomy: Tiny blades slice through the plaque in a circular motion.  

We will repeat this process if you have more than one blocked or narrowed blood vessel. 

Recovery After Coronary Atherectomy 

To prevent any bleeding, you will need to lie flat for six hours after the procedure. We will monitor your blood pressure, heart rate and pulse as you recover. 

You will need to rest and relax for a few days after you return home. We will schedule your follow-up visit for seven to 10 days after your procedure. In the meantime, avoid strenuous activity for two to three weeks. As you recover, let us know if you experience any of these complications: 

• Discharge, redness or swelling at the catheter insertion site 
• Pain in your leg or groin 
• Temperature changes in your treated leg 

Coronary atherectomy doesn’t prevent blockages in other blood vessels. To keep your heart healthy and protect your blood flow, practice these lifestyle behaviors: 

• Eat a diet low in saturated fat that includes fruits, vegetables and whole grains 
• Exercise regularly 
• Maintain healthy blood pressure, blood sugar and cholesterol levels 
• Maintain a healthy weight for you 
• Quit smoking or using other tobacco products