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Rotational atherectomy (RA) is a surgical procedure performed by an interventional cardiologist to open up arteries that are clogged or narrowed as a result of plaque build-up.

Ideal Candidate for Rotational Atherectomy

Patients with coronary heart disease may occasionally be given the option of rotational atherectomy. With coronary artery disease, blockage of the arteries due to the obstruction of blood flow around the heart caused by the accumulation of plaque may occur. Complete obstruction can result in a heart attack or stroke.

The following are situations whereby rotational atherectomy might be a suitable treatment option:

  • Rotational atherectomy can be utilized to treat areas of the artery that may be too difficult to access using the tools used in an angioplasty.
  • In the event that some arteries reject stents and continue to narrow, rotational atherectomy can be performed to remove the first set of stents and get the area ready for better stenting later.
  • The arteries in older patients are significantly tougher and often not flexible enough to be immediately dilated with stents. Therefore, to enable stenting, a rotational atherectomy can remove a portion of the plaque and separate it from the arterial wall.

The Procedure

Rotational atherectomy is a minimally invasive procedure that involves a small incision near the groin area. The procedure is performed under local anesthesia.

During the procedure, the surgeon will insert a catheter, which is a small, flexible tube into the affected artery before feeding the atherectomy wire through the catheter. The atherectomy wire is very thin with a rotating head known as a burr which comes in different sizes depending on the size of the artery that is being treated.

The surgeon then applies a burr to the blockage and gently removes the accumulated plaque. After the plaque has been removed, the surgeon will likely finish the treatment by dilating the artery with balloon angioplasty and inserting a stent to keep it open.

What Happens After Rotational Atherectomy

After the procedure, most patients will spend the night in the hospital in case the surgeon needs to address any issues.

Patients may be instructed to refrain from vigorous activity for the upcoming several weeks in order to aid in their recuperation, and they may require blood-thinning medication in the long term

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