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Coronary Directional Atherectomy

Directional atherectomy is a procedure during which the plaque in your coronary arteries is shaved from the arterial walls.

A special catheter is used for this procedure. Its tip contains a small cylindrical rotating cutting blade. This blade is encased in a metal housing. There is an opening on one side and a balloon on the other side. On the end of the tip is a small plastic cone which collects the shaved plaque fragments.

Why has my doctor ordered this procedure for me?
The reasons for ordering directional atherectomy are the same as for rotational atherectomy.

Are there any risks associated with this procedure?
The risks of directional atherectomy are fairly low. They include the same risks as balloon angioplasty.

What preparations should I make before the procedure?
The preparations are similar to those made for the rotational atherectomy.

What happens during the procedure?
The procedure resembles coronary angioplasty up until the point after the guiding catheters are inserted. After these are in place, and guiding pictures have been taken to confirm the sites of the plaque, you will be given some intravenous medications.

The cutting catheter is advanced over the guidewire to the site of the plaque. The balloon is inflated and the cutter is pressed against the plaque. When the cutting blade is rotated at 2000 rpm , it shaves the plaque from the arterial wall. The plaque fragments are collected in the cone. When the catheter is withdrawn, the plaque fragments are removed from the cone.

How long does the procedure take?
The procedure takes from one to three hours.

What happens before I'm discharged from the hospital?
From this point on, the procedure is the same as for balloon angioplasty.

arterial walls. The lumen are thus widened. Then the balloon is removed. This procedure may be repeated with additional arteries.


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