Doctor insights on:
PI: It is a percutaneous intervention -- a vascular procedure like 'scrapping' the vascular wall of layers of plaques. ...Read more
Atherectomy v balloo: Typically blocked arteries can be opened more widely by inflating a balloon inside the vessel. The balloon is then deflated and removed from the vessels. At times, heavy calcium makes the arteries so hard they won't open w/ the balloon. Some of those lesions can be addressed w/ Atherectomy, a device that shaves the plaque down creating a more wide flow channel. ...Read more
Yes: Angiography and atherectomy are both performed through the same approach, namely inserting a catheter into an artery, usually the artery at the groin. The angiography is performed first. If this reveals a plaque in the artery accounting for the symptoms, the catheter can be exchanged for another type of catheter that can carry out the atherectomy. ...Read more
Same as angioplasty: This should not feel any different from a regular angioplasty. As far as long term effects, the usual patient for atherectomy does not have very good anatomy and that is primarily the reason atherectomy is used. Hard, calcified plaques are usually not amenable to other methods of angioplasty. There are many cases when atherectomy is combined with stenting which is usually a better outcome. ...Read more
Different: Atherectomy is not better than stenting, it usually is reserved for cases when a balloon angioplasty combined with stenting, or direct stenting can not be accomplished due to the plaque burden. In those cases atherectomy is used to debulk the plaque and the best result would be if this can then be supplemented with a stenting to prevent plaque regrowth or near-term closure of the vessel. ...Read more
No: Bypass if needed and possible is a better form of revascularization. To this day, and to the best of my knowledge, there have not been any studies that show angioplasty of any kind has a better long-term outcome than bypass surgery. ...Read more
It's just an option.: Vascular surgeons and their patients are often presented with a complex series of choices and operative approaches. There are always different approaches that can be taken. This includes minimally invasive techniques, open surgery, or hybrid approaches that combined both. I use the approach you mention when patients do not have any vein for a bypass and have pain at rest. Can be effective. ...Read more
Atherectomy/Stent: Two different kinds of procedures done in different types of situations while treating blocks in heart arteries. Those are not substitute to each other. ...Read more
Very long: State of the art procedures can cross lesions as long as 200mm. .. That's 20cm and about 8 inches... Or even longer lesions. ...Read more
Long term bur can restenose need regular follow up Doppler
Removing plaque: Atherectomy is the removal of plaque build up in the lining of an artery. The plaque causes a narrowing of the arterial lumen decreasing blood flow. By removing the plaque, there is increased flow in that artery. It can be done by a variety of techniques: using a laser, or devices that act like a plane to shave the plaque and others that are like a drill or file. ...Read more
Is it possible that atherectomy open a totally occluded leg artery or just a leg artery that has narrowed considerably?
100% Vs: If totally occluded (100% blocked) and it's chronic it can't be opened. If it's 99% blocked and a guide wire can be placed across the blockage, it may be possible to open the artery using angioplasty or atherectomy. If the vessel can't be approached or is too tortuous or peripheral intervention, it may be possible to bypass it with open surgery. ...Read more
Is vascular lithotripsy on a femoral lesion an effective and safe means of plaque ablation? Any better than atherectomy or endarterectomy?
No: There is no role for lithotripsy in the treatment of peripheral arterial disease. Lithotripsy is a procedure primarily designed to break up kidney stones. If the procedure were used on arteries, the fragments might break off and further damage arteries downstream. The treatment for atherosclerotic related arterial disease includes medical management, the minimally invasive procedures you mentioned, and open procedures. Experienced vascular surgeons can offer all three methods. ...Read more
Very effective: Rotational atherectomy is a niche tool. Some kinds of coronary blockages are not amenable to stenting, particularly those which contain a large amount of calcium. These blockages are very hard and the stent cannot easily expand. Rotational atherectomy is very effective in opening heavily calcified arteries. Rotational atherectomy is not required in the majority of angioplasties. ...Read more
Coronary CT angiogram shows extremely high calcium score of 4242 and ~ 70% blockage one artery. Next step cath angio. Should I consider atherectomy?
NO: You need a coronary angiogram-depending what it shows, you may need revascularization. Depending on location and extent, you may need surgery. Otherwise, balloon angioplasty followed by stenting is the treatment of choice. Atherectomy has a very limited and specific indication. If you need it, your interventionalist is the one to make the call. ...Read more