Atherectomy

Atherectomy
Intervention
Illustration of three types of atherectomy devices being used to remove plaque in a blood vessel
ICD-9-CM	39.50, 00.61 -00.62
MeSH	D017073

Atherectomy is a minimally invasive endovascular surgery technique for removing atherosclerosis from blood vessels within the body. It is an alternative to angioplasty for the treatment of peripheral artery disease, with no evidence of superiority to angioplasty.^[1] It has also been used to treat coronary artery disease, albeit ineffectively.^[2]

Uses

Atherectomy is used to treat narrowing in arteries caused by peripheral artery disease.

Technique

Unlike angioplasty and stents, which push plaque into the vessel wall, atherectomy cuts plaque from the wall of the artery. While atherectomy is usually employed to treat arteries it can be used in veins and vascular bypass grafts as well.

Atherectomy falls under the general category of percutaneous revascularization, which implies re-canalizing blocked vasculature via a needle puncture in the skin. The most common access point is near the groin through the common femoral artery (CFA). Other common places are the brachial artery, radial artery, popliteal artery, dorsalis pedis, and others.

There are four types of atherectomy devices: orbital, rotational, laser, and directional.

The decision to use which type of device is made by the interventionist, based on a number of factors. They include the type of lesion being treated, the physician's experience with each device, and interpretation of the devices' risks and effectiveness, based on a review of the medical literature.

References

↑ Ambler, GK; Radwan, R; Hayes, PD; Twine, CP (17 March 2014). "Atherectomy for peripheral arterial disease.". The Cochrane database of systematic reviews 3: CD006680. doi:10.1002/14651858.CD006680.pub2. PMID 24638972.
↑ Wasiak J, Law J, Watson P, Spinks A (December 2012). "Percutaneous transluminal rotational atherectomy for coronary artery disease". Cochrane Summaries.

Vascular surgery ICD-9-CM V3 38–39, ICD-10-PCS 03–6

Vascular and
Endovascular surgery

Arterial disease	Vascular bypass Angioplasty Atherectomy Endarterectomy Carotid endarterectomy Stenting Carotid stenting

Venous disease	Ambulatory phlebectomy Laser surgery Sclerotherapy Vein stripping

Arterial and Venous Access	Venous cutdown Arteriotomy Phlebotomy

Aortic aneurysm / dissection:	Endovascular aneurysm repair Open aortic surgery

Other	Cardiopulmonary bypass Cardioplegia Extracorporeal membrane oxygenation Hemodialysis Revascularization Glomectomy First rib resection Seldinger technique Vascular snare

Medical imaging

Angiography	Digital subtraction angiography Cerebral angiography Aortography Fluorescein angiography Radionuclide angiography Magnetic resonance angiography

Venography	Portography Impedance phlebography

Ultrasound	Intravascular ultrasound Carotid ultrasonography

Other diagnostic

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Atherectomy

Uses

Technique

See also

References