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What Is an Atherectomy?

If you've been diagnosed with peripheral artery disease (PAD), your doctor may have suggested an atherectomy. This non-surgical treatment is often used for patients with PAD: it can also be used to treat atherosclerosis in patients with coronary artery disease. 

PAD is typically caused by a buildup of plaque on the walls of the arteries that supply oxygen-rich blood to your legs. These plaque deposits, also called atherosclerosis, narrow and harden the artery walls. Blockage of the arteries makes it more difficult for blood to circulate, which can lead to more serious health conditions like stroke, heart attack, or amputation.   

PAD treatment addresses plaque within the arteries, so blood can once again travel freely. Some treatments, such as stents, physically create a passageway for blood flow by pushing plaque buildup towards the walls of the arteries with a mesh piece that permanently stays in the artery. In comparison, a PAD atherectomy completely removes the plaque from the artery.

Atherectomy Procedure

During an atherectomy procedure, you’ll receive a light sedative and a local anesthetic to numb the groin or upper thigh, where a thin catheter tube will be inserted. The vascular specialist will then carefully guide the catheter through your arteries to the location of the blockage. Then, the vascular specialist will send a dye through the catheter to your arteries so they can see the plaque buildup. The catheter eliminates the plaque using a  laser or a tiny blade. As the catheter shaves the plaque off of the arterial walls, it will collect the buildup in a chamber in the tip. When the blockage is removed, the specialist will remove the catheter that holds the plaque. This makes sure that the plaque accumulation does not stay within the body and is physically removed.

After the catheter is removed, you’ll stay for a brief observation period before going home. The entire procedure takes less than two hours from start to finish, and an atherectomy can be followed up with the placement of a stent if necessary. 

Atherectomy offers several benefits. Because it is minimally invasive, there is a lower risk of infection and less pain than a surgical procedure. There aren't any major sutures that need to heal, just the small incision, which also means you won’t have to deal with post-op stitches.

Our experienced vascular specialists will go over every step of an atherectomy and outline the details for you. You will receive instructions to follow in the days leading up to your treatment appointment, such as stopping certain medications like blood thinners. During the atherectomy, our care team monitors you carefully to ensure you’re comfortable during the process. 

Atherectomy Devices

A catheter is the main device used in an atherectomy. Depending on how it’s equipped, it can be used in at least four ways: 

  • Directional atherectomy: A tiny blade at the end of the catheter cuts away plaque from the artery wall. The fatty deposits are stored in a special container on the catheter.  When the catheter is removed from your body, so is the plaque.
  • Orbital atherectomy: The blade on the catheter’s tip rotates, and this spinning action grinds away the plaque buildup. 
  • Rotational atherectomy: A burr embedded with tiny diamond chips quickly spins at the tip of the catheter to pulverize plaque into microscopic particles.
  • Laser atherectomy: High-energy light vaporizes plaque.

All four types of catheters are minimally invasive, which makes atherectomy a more advanced treatment for PAD than surgery.

What to Expect After an Atherectomy

You’ll be resting, usually by lying flat on your back, immediately after the treatment so you can recuperate. A bandage or other dressing will cover the insertion point, and there may be pressure applied to stop any bleeding. You’ll be observed for a little while to ensure that there’s no bruising, swelling, or bleeding.

Your specialist will give you detailed instructions to follow for your at-home care. You may also get a prescription for a blood thinner. Heavy lifting and strenuous exercise will have to wait for a week or so, but you can still do lighter activities, including walking.  You will be able to drive because atherectomy uses local rather than general anesthesia. You should avoid soaking in water, such as a bath or hot tub, while the catheter incision site heals. 

Your vascular specialist will also want to schedule a follow-up appointment to check your progress. In the meantime, contact your specialist if you see any issues (redness or swelling) at the incision, experience fever or other signs of potential infection, or feel intense pain.

Successful atherectomy for peripheral artery disease can reduce the pain and cramps you feel in your legs, making it much easier to function in daily life again. Avoiding secondhand smoke and foods high in sodium, sugar, as well as saturated fat may help PAD symptoms from returning.

Schedule a Consultation With USA Vascular Today

Your vascular health is important, because without treatment, PAD may lead to serious complications. Seek care from our trusted doctors to improve your health and quality of life. 

USA Vascular Centers specializes in non-surgical PAD treatments. Our skilled specialists work with you to determine a diagnosis and develop a personalized course of treatment that can bring you the best results. Your treatment plan may include lifestyle changes, medications, and treatments that ease PAD symptoms. 

We aim to transform your health and life through high-quality, compassionate vascular care.  Take the first step with us by calling  888.773.2193 or requesting a consultation today.  At USA Vascular Centers, we want to make treatment for PAD as easy as possible. That’s why we have convenient locations nationwide, and offer virtual appointments. When you’re ready to take the next step towards a healthier, more active life, we’re here to help. 

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