Atherectomy

What is Atherectomy

Atherectomy is a surgical procedure to remove a buildup of fat, cholesterol, and other substances (plaque) from the inside of an artery. Arteries are the blood vessels that carry blood from the heart to the rest of the body.

A buildup of plaque in the arteries can block blood flow. In this procedure, plaque is removed from an artery using a device at the end of a thin, flexible tube (catheter).

A narrow tube of wire mesh (stent) may be placed in the artery to prevent it from getting blocked again.

You may have this procedure to remove plaque from the arteries of your heart (coronary arteries). You can also have this procedure to clear arteries in other parts of your body, such as the arteries that provide blood to your legs.

Tell a health care provider about:

  • Any allergies you have.
  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
  • Any problems you or family members have had with anesthetic medicines.
  • Any blood disorders you have.
  • Any surgeries you have had.
  • Any medical conditions you have.
  • Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

  • Infection.
  • Bleeding.
  • Allergic reactions to medicines or dyes.
  • Damage to other structures or organs.
  • Inability to open the blocked artery.
  • Artery rupture.
  • Heart attack (if the procedure is done on a heart artery).
  • Amputation (if the procedure is done on a leg artery).
  • Return of the blockage or clotting.
  • A blood clot that can lead to a stroke.

What happens before the procedure?

  • Ask your health care provider about:
    • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
    • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood.Do not take these medicines unless your health care provider tells you to take them.
    • Taking over-the-counter medicines, vitamins, herbs, and supplements.
  • Follow instructions from your health care provider about eating or drinking restrictions.
  • Plan to have someone take you home from the hospital or clinic.
  • Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.
  • You may be given antibiotic medicine to help prevent an infection.
  • You may be asked to shower with a germ-killing soap.

What happens during the procedure?

  • To lower your risk of infection:
    • Your health care team will wash or sanitize their hands.
    • Hair may be removed from your groin area.
    • Your skin will be washed with soap.
  • An IV will be inserted into one of your veins.
  • Sticky patches (electrodes) will be placed on your chest to monitor your heart rhythm.
  • You will be given one or more of the following:
    • A medicine to help you relax (sedative).
    • A medicine to numb the groin or wrist area (local anesthetic).
  • Your health care provider will make a small incision in your groin area or wrist and identify the needed artery.
  • A catheter will be put into the artery and guided to the location of the plaque. Your health care provider will use X-ray images to guide the catheter to the right spot.
  • Dye will be injected into the artery after the catheter is in the correct position.
  • Your health care provider will use an instrument that is inserted through the catheter to cut away pieces of plaque. The pieces will be stored in part of the catheter so they can be removed.
  • A stent will likely be put in place to keep your artery open.
  • The catheter will be removed.
  • The incision will be closed and covered with a certain type of bandage (pressure dressing).

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

  • Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
  • After several hours, you will be encouraged to get up and walk around.
  • Do notdrive for 24 hours if you were given a sedative during your procedure.

Summary

  • An atherectomy is a surgical procedure to remove a buildup of fat, cholesterol, and other substances (plaque) from the inside of an artery.
  • In this procedure, plaque is removed from an artery using a device at the end of a thin, flexible tube (catheter). A narrow tube of wire mesh (stent) will likely be placed in the artery to prevent it from getting blocked again.
  • Before the procedure, ask your health care provider about changing or stopping your regular medicines. Also follow any instructions about eating or drinking restrictions.

Atherectomy, Care After

What can I expect after the procedure?

After the procedure, it is common to have:

  • A tender lump in your groin or wrist.
  • Bruising.
  • Soreness.

Follow these instructions at home:

Incision site care

  • Follow instructions from your health care provider about how to take care of your incision. Make sure you:
    • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
    • Change your dressing as told by your health care provider.
    • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do notremove adhesive strips completely unless your health care provider tells you to do that.
  • Check your incision area every day for signs of infection. Check for:
    • Redness, swelling, or pain.
    • Fluid or blood.
    • Warmth.
    • Pus or a bad smell.

Do nottake baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you may take showers.

Activity

  • Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
  • Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that you are told, until your health care provider says that it is safe.
  • Do not drive for 24 hours if you were given a medicine to help you relax (sedative) during your procedure.

Lifestyle

  • Make any lifestyle changes as recommended by your health care provider. These may include:
    • Not using any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
    • Managing your weight.
    • Getting exercise on a regular basis.
    • Managing your blood pressure.
    • Limiting your alcohol intake.
    • Managing other health problems, such as diabetes.
  • Eat a healthy diet. This should include plenty of fresh fruits and vegetables. Avoid foods that are:
    • High in salt (sodium).
    • Canned or highly processed.
    • High in saturated fat or sugar.
    • Fried.

General instructions

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Drink enough fluid to keep your urine pale yellow.

Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • You have a fever or chills.
  • You have redness, swelling, or pain around your incision.
  • You have fluid or blood coming from your incision.
  • Your incision area feels warm to the touch.
  • You have pus or a bad smell coming from your incision.

Get help right away if:

  • You have uncontrolled bleeding at your incision site.
  • You have chest pain.
  • You have trouble breathing.
  • Your toes are blue, discolored, or painful.

Summary

  • After the procedure, it is common to have soreness, bruising, or a tender lump in your groin or wrist where the catheter was inserted.
  • Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
  • Follow instructions from your health care provider about how to take care of your incision. Check your incision area every day for signs of infection.
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