PAD: Atherectomy

Overview

Peripheral Artery Disease Intervention Treatments: Jaikirshan Khatri, MD

What is an atherectomy for atherosclerosis/PAD/PVD?

An atherectomy is a procedure that utilizes a catheter with a sharp blade on the end to remove plaque from a blood vessel. The catheter is inserted into the artery through a small puncture in the artery, and it is performed under local anesthesia. The catheter is designed to collect the removed plaque in a chamber in the tip, which allows removal of the plaque as the device is removed from the artery. The process can be repeated at the time the treatment is performed to remove a significant amount of disease from the artery, thus eliminating a blockage from atherosclerotic disease.

Why is this atherosclerosis atherectomy procedure performed? Why do I need this procedure?

The goal of treatment is to eliminate the build-up of plaque in your arteries.

You may need this atherectomy procedure if your arteries become too narrowed or blocked from plaque inside the artery walls. If arteries are blocked, blood cannot get through to nourish the tissues, causing the muscles of the lower extremities to cramp and lose strength.

An atherectomy is especially helpful for treating blockages in arteries that occur around branches or in vessels that are not easily treated with stents.

This procedure is not ideal for everyone. Each patient is evaluated, and treatment will be individualized for the patient's circumstances.

Where is the atherectomy procedure performed and who performs this procedure?

This procedure is performed in the hospital surgical, interventional, or catheterization suite by a trained vascular surgeon.

Doctors vary in quality due to differences in training and experience; hospitals differ in the number of services available. The more complex your medical problem, the greater these differences in quality become and the more they matter.

Clearly, the doctor and hospital that you choose for complex, specialized medical care will have a direct impact on how well you do. To help you make this choice, please review our Miller Family Heart, Vascular & Thoracic Institute Outcomes.

Procedure Details

How do I prepare for the atherectomy?

A few days before the procedure, pre-procedure tests may be performed to ensure that it is safe to continue with the procedure. You may need to discontinue certain medications before the procedure. Your health care team will provide specific instructions to help you prepare.

What happens during the procedure?

The atherosclerosis atherectomy will be performed under local anesthesia with a mild sedative given intravenously. Your surgeon will insert a catheter equipped with a sharp blade at its tip and advance it through your artery until it reaches the area of narrowing. Your surgeon will then scrape away the plaque with the catheter blade. The plaque will be collected in a chamber in the tip of the catheter for removal. The surgeon may need to pass the catheter multiple times in order to remove a significant amount of atherosclerosis.

How long does the atherectomy procedure last?

The procedure itself generally takes two hours, but the preparation and recovery time add several hours. Following the procedure, you will need to lie flat for three to six hours. The surgery may require a minimum hospital stay of one to two days.

What happens after the procedure?

You can usually begin normal activities again several days after the atherectomy. Your doctor will provide specific guidelines for your recovery.

Risks / Benefits

What are the risks and potential complications of the procedure?

Your doctor will discuss the specific risks and potential benefits of the recommended procedure with you.Atherectomy usually has no complications, but as with any surgery, there is a risk of complications, such as embolization (the dislodgement of debris that blocks the arteries in the lower part of the leg) and perforation. These complications, however, are rare. An unusual complication of atherectomy is the re-blockage of the artery (restenosis) that may occur later, especially if you smoke cigarettes.Special precautions are taken to decrease these risks, and there may be other possible risks. When you meet with your doctor, please ask questions to make sure you understand the risks of the procedure and why the procedure is recommended.To find out if you are a candidate for this procedure, please call the Vascular Surgery Department at 216.444.4508 or 800.223.2273 ext. 44508.

Are there any side effects of the treatment?

There are typically no side effects from the treatment.

Recovery and Outlook

What are the results of the procedure?

Atherectomy usually provides good relief of symptoms of atherosclerosis. Your doctor will discuss the results of the procedure with you. However, unless a healthy lifestyle is adopted, atherosclerosis can recur.

Resources

Contact

If you need more information, click here to contact us, chat online with a nurse or call the Miller Family Heart, Vascular & Thoracic Institute Resource & Information Nurse at 216.445.9288 or toll-free at 866.289.6911. We would be happy to help you.

Doctors vary in quality due to differences in training and experience; hospitals differ in the number of services available. The more complex your medical problem, the greater these differences in quality become and the more they matter.

Clearly, the doctor and hospital that you choose for complex, specialized medical care will have a direct impact on how well you do. To help you make this choice, please review our Miller Family Heart, Vascular & Thoracic Institute Outcomes.

Cleveland Clinic Heart, Vascular & Thoracic Institute Vascular Medicine Specialists and Surgeons

Choosing a doctor to treat your vascular disease depends on where you are in your diagnosis and treatment. The following Heart, Vascular & Thoracic Institute Sections and Departments treat patients with all types of vascular disease, including blood clotting disorders:

Section of Vascular Medicine: for evaluation, medical management or interventional procedures to treat vascular disease. In addition, the Non-Invasive Laboratory includes state-of-the art computerized imaging equipment to assist in diagnosing vascular disease, without added discomfort to the patient. Call Vascular Medicine Appointments, toll-free 800-223-2273, extension 44420 or request an appointment online.

Department of Vascular Surgery: surgery evaluation for surgical treatment of vascular disease, including aorta, peripheral artery, and venous disease. Call Vascular Surgery Appointments, toll-free 800-223-2273, extension 44508 or request an appointment online.

IVC Filter Retrieval Clinic - to make an appointment, call Vascular Medicine at 216.444.4420. Ask for Dr. Bartholomew in the Filter Retrieval Clinic. Your appointment will include a consultation with Dr. Bartholomew and the physicians who will perform the IVC filter retrieval procedure.

You may also use our MyConsult second opinion consultation using the Internet.

The Heart, Vascular & Thoracic Institute also has specialized centers and clinics to treat certain populations of patients:

Learn more about experts who specialize in the diagnosis and treatment of vascular and arterial disease.

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Last reviewed by a Cleveland Clinic medical professional on 05/17/2019.

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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy