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Presbyterian Heart and Vascular Care Providers

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Coronary Atherectomy

Coronary atherectomy is a minimally invasive procedure to remove arterial blockage (plaque) in the coronary arteries to improve blood flow to the heart and relieve pain. The plaque is removed using a rotating shaver or laser.

Why choose Presbyterian for your coronary atherectomy?

Presbyterian Heart and Vascular Care has a skilled vascular care team who can provide a wide range of services from diagnosis to treatment. Their surgeons are trained in many different techniques and procedures, many of which can provide you with a shorter recovery period and less hospital time.

Who is eligible for a coronary atherectomy?

You may need a coronary atherectomy if:

  • You have had a heart attack.
  • You have coronary artery disease (CAD).
  • Medications have not improved blood flow.
  • You have angina (chest pain) and shortness of breath.
  • You have a coronary artery bypass graft that has closed or narrowed.
  • Your doctor determines that the plaque will respond to atherectomy and that it can be reached with a catheter.
  • You have only one or two blocked or narrowed coronary arteries. If more coronary arteries are involved, your doctor may recommend coronary bypass grafting instead of atherectomy.

What conditions can be treated with a coronary atherectomy?

Coronary atherectomy treats coronary artery disease (CAD). CAD occurs when fatty deposits build up on coronary artery walls and harden into a substance called plaque. As plaque builds on coronary artery walls, the artery narrows.

Eventually, a serious blockage can occur, and blood will not flow through the coronary artery properly. The blockage increases the risk that a blood clot forms, blocks the coronary artery, and results in a heart attack.

How do I prepare for a coronary atherectomy?

You can prepare for coronary atherectomy by:

  • Answering all questions about your medical history and any prescribed medications, over-the-counter drugs, herbal treatments, and vitamins you are taking.

  • Following instructions about eating and drinking before coronary atherectomy.

  • Your doctor will give you specific instructions about taking your medications before the procedure.

What should I expect during my coronary atherectomy?

Your coronary atherectomy will be performed in a cardiac catheterization laboratory. The procedure takes 1-2 hours and includes these steps:

  • A doctor or nurse will insert an intravenous (IV) line to provide fluids and medications.

  • They will attach devices to monitor your heart rate, blood pressure, and other functions.

  • You will have a blood test to verify normal kidney function and blood clotting.

  • You will be given a light sedative to make you drowsy and relaxed. Patients sometimes have deeper sedation or anesthesia through the IV. You may have medication to prevent blood clots from forming in your arteries.

  • The procedure team will shave and clean your groin or arm. Your doctor will numb the area and make a small incision.

  • Your doctor will insert a tiny tube (catheter) and guide wire through the incision. The catheter is fed into the artery that needs an atherectomy. X-rays guide the wire to the exact location.

  • Your doctor will inject a contrast agent through the catheter to improve the quality of the X-ray images.

  • Your doctor will grind or shave away the blockage to open or widen your coronary artery. A stent may be placed to keep it open.

  • Your team may take additional X-rays to verify that blood is flowing as it should. Your doctor will then remove the catheter and close the catheter site.

How do I care for myself after my coronary atherectomy?

It is important to keep your follow-up appointments after coronary atherectomy. Call your doctor right away if you have:

  • Fever.

  • Bleeding.

  • Chest pain.

  • Dizziness.

  • Pain that is not controlled by your pain medication.

  • Unusual swelling, redness, or warmth around your incision.

  • Color change in the arm or leg used to insert the catheter.

  • Numbness or a feeling of coolness in the arm or leg used to insert the catheter.