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Atherectomy Procedure

During an atherectomy procedure, a special pulverizing device is used to get rid of blockages in the coronary artery. Your doctor may decide to place a stent at this time as well. This usually helps keep the artery open for a longer period of time. In some cases, the atherectomy procedure is accompanied by a balloon angioplasty, which also helps expand the coronary artery.

What Is an Angioplasty?

An atherectomy is a procedure used to open hardened blockages in your coronary arteries with a special pulverizing device. This is often performed during a balloon angioplasty. In many cases, an expandable device, called a stent, is inserted into your blocked artery after an angioplasty or atherectomy. Stents can help the artery remain open for a longer period of time.

Beginning the Atherectomy Procedure

To begin an atherectomy, your doctor chooses an artery for the catheter entry site. Most commonly, an artery in the groin area of the leg is used; however, an artery in the bend of the elbow may also be used. Once this site is chosen, the area will be scrubbed with a special disinfectant soap and may also be shaved.
Your doctor will then numb the area with some numbing medication. Once the area is numb, your doctor will insert an introducer -- which is a small, hollow, plastic tube -- into your artery. You may feel some pressure or slight discomfort as the needle guides the introducer into the artery. A guide wire is then lowered into your artery, and a catheter -- another small, flexible, hollow tube -- is then inserted over the wire and carefully advanced into your heart, through the aorta, and to the coronary arteries. The catheter movement is viewed on an x-ray screen.
You will not feel the catheter as it moves through your blood vessels, although you may experience the feeling of a "skipped" heartbeat as the catheter moves through your heart. This is normal.
Once the catheter reaches the coronary arteries, dye is injected into them. You may feel a heat flash or some nausea for about 30 seconds when the dye is injected. This special dye shows up on the x-ray screen and allows your doctor to see any blockages that may be present. Your doctor will repeat the injection of dye several times, looking at the arteries from many different angles.
After your arteries have been examined, the catheter will be redirected to your left ventricle. You will feel a heat flash for 20 to 30 seconds when a large amount of dye is injected into the ventricle. This tests how your ventricle is contracting and if your valves are functioning properly.
During the procedure, your doctor will talk to you, explaining each step along the way. Your participation and feedback will be needed. For example, you may be asked to cough to help move the dye out of your coronary arteries. Also, you will be asked to hold your breath for three to five seconds while x-ray pictures are being taken to prevent blurring of the pictures.
During the atherectomy, it is important to let your doctor know if you are experiencing any of the following symptoms:
  • Chest or back pain
  • A tight, squeezing feeling in your chest or between your shoulder blades
  • Shortness of breath
  • A severe headache
  • Dizziness
  • Changes in your vision.
These sensations might indicate that something is not right.
Ouch! 6 Types of Pain You Might Experience When Getting a Stent

Coronary Atherectomy

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