Coronary Atherectomy

Coronary plaque is a build-up of cholesterol, fat, and calcium, which can, over time, narrow your arteries and potentially close off blood flow to your heart. Normally, the walls of your hollow, tube-shaped arteries are smooth and elastic.

Altherosclerosis occurs when the lining of your arteries deteriorate and thicken with plaque deposits and is commonly known as “hardening of the arteries” or coronary heart disease.

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If your diagnostic angiogram suggests a blockage which is not easily fixed with a traditional balloon or stent procedure, you may be a candidate for an atherectomy procedure. This procedure literally scrapes the plaque from the walls of your arteries. By inserting a special catheter with a rotating tip, your doctor removes the plaque until blood begins to flow freely through your arteries. 

Your physician may consider the following factors before performing an atherectomy:

• The location or shape of plaque deposit;
• The size or anatomy of your arteries;
• Whether the plaque is exceptionally hard, or calcified; and
• Whether clots are present in the artery.

Before the procedure

• Notify your doctor of any bleeding problems you may have, if you are taking coumadin or other blood thinning medication, or if you are allergic to iodine.
• If you are a diabetic, a change may be required in your insulin or pill regimen on the morning of the procedure.
• Patients with a history of kidney problems may require special preparation.
• Eat a normal meal the evening before your procedure. DO NOT eat, drink or chew anything after 12 midnight
• Ask your doctor what medications you are allowed to take.
• If you must take medications, take with a small sip of water.  
• Bring all current medications with you including the dosage and number of times you take the medication during a 24 hour period.
• A few days before your scheduled procedure, your doctor may order standard tests, such as an electrocardiogram, chest x-ray, or routine blood tests.

During the procedure

• An IV (intravenous line) inserted in your arm administers sedatives, medications, and fluids during the procedure.
• The site of your catheter insertion site (most often the right groin area) will be cleansed with an antiseptic soap and shaved and numbed with a local anesthetic.
• A tiny incision will be made in the skin. Your doctor guides a thin, flexible wire you’re your blood vessel to your heart.
• Your doctor inserts a catheter through a sheath, slides it over the guide wire, and guides it into your coronary arteries. 
• Once the catheter reaches your heart, a liquid dye (contrast fluid) is injected; your doctor can view your heart and arteries on a special screen called an angiogram.
• You may be asked to hold your breath for five to ten seconds while some of the photos of your heart are taken, and you may also be asked to cough a few times after the dye has been injected.
• A burr-tipped catheter is inserted and guided to the blocked portion of your artery to remove the plaque.
• When the plaque is removed, blood flow to your heart is restored.
• Following the altherectormy, an angioplasty and a stent procedure may be performed to widen the artery.
• The procedure lasts one to three hours.

After the procedure

• Your doctor removes the catheter.
• You will be admitted to the hospital overnight for monitoring.
• You may experience some minor chest discomfort. Bruising around the catheter insertion site may develop.
• Drink lots of fluids.
• Notify your doctor if your chest pain is significant or if swelling occurs around the insertion site.
• Patients may resume normal activities after two days.
• Follow-up appointments will be necessary.

Addressing lifestyle causes to altheroschlerosis is central to maintaining a healthy cardiovascular system. Patients are encouraged to:

• Eat a healthy diet
• Exercise
• Lose weight
• Quit smoking

Physicians

• Mark Bieniarz, MD
• Robert E. Federici, MD
• Geoffrey A. Kunz, MD
• Kimber M. Stout, MD
• Howard S. Zeman, MD
• Mark Zolnick, MD

Locations

• Albuquerque, 502 Elm Street NE (505) 841-1000
• Santa Fe, 2085 S. Pacheco Street (505) 984-8012

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Altherosclerosis Video