|
Atherectomy
Atherectomy is a procedure that your doctor may recommend to remove certain types of plaque that block your coronary arteries. The goal of this procedure is to improve the flow of blood to your heart. An atherectomy catheter has a special rotating burr on its tip that is used to shave away the plaque inside your artery. Following catheterization and angiography, this plaque-shaving device is inserted through the catheter, then carefully steered through the vessel to your blocked coronary artery. Your cardiologist will then use the specialized burr-tipped catheter to remove the plaque in your blood vessel. Angioplasty or stent implantation may immediately follow the atherectomy to further reduce the possibility of re-narrowing in your opened coronary artery. The Cardiovascular Laboratory staff at Abbott-Northwestern Hospital will answer any further questions you or your family may have about this procedure.
Well in advance of your procedure, make sure your primary care provider is aware of any bleeding problems you may have, or if you are taking coumadin or other blood thinning medication. You should also tell your primary doctor if you are allergic to seafood or iodine, or if you have a history of allergic reaction to dye used in previous procedures. A change may be required in the diabetic patient’s insulin or pill regimen on the morning of the procedure. Prior to the day of the procedure, diabetics should discuss any possible changes with their physicians. Patients with a history of kidney problems will occasionally require special preparation. Your physician will determine your preparation needs based on the nature and severity of your kidney problem. Your primary doctor will likely request some standard tests, such as an electrocardiogram, chest x-ray or routine blood tests, that should be completed at your community clinic or hospital prior to your procedure at MHI. The results of these tests are sent to Minneapolis Heart Institute in preparation for your coronary angiogram and atherectomy procedure.
You will be asked to not eat or drink anything for at least six hours before the procedure. Routine medications should be taken the morning of your procedure with small sips of water, unless otherwise instructed by your physician. When you get to the Abbott Northwestern Hospital campus, you should report to the Day Angiogram admitting desk in the Piper Building lobby (on the northeast corner of the campus, on the corner of 26th Street and 10th Avenue; Choose from the following links to view maps and directions or a campus guide.) You will then be taken to the Cardiovascular Outpatient Care Unit to prepare for the procedure. In preparation for your procedure, your catheter insertion site will be shaved, an IV (intravenous line) will be started, blood work will be taken (if appropriate), a 12-lead ECG will be obtained and necessary forms will be completed. If you had not seen a Minneapolis Heart Institute cardiologist prior to the day of your procedure, one will see you to fully explain the procedure and he or she will follow you through your hospital stay. *Please note: the physician overseeing your care may not be the physician actually performing the procedure. During the procedure, your family may wait comfortably in a special area in the day angiogram unit. After the preparation phase, your family may come back and stay with you until you are taken for your procedure. When the procedure room is ready, you will be transported to the lower level of Abbott-Northwestern Hospital where the CV lab is located. Your family may take a break (i.e. breakfast, lunch) and return to the same family room as before.
During the procedure, you will receive fluids and medication (to help you relax) through an IV (intravenous) line. You will not be anesthetized (“put to sleep”) during the atherectomy procedure. A local anesthetic will be injected to numb the site where the catheter will be inserted, so you should feel little to no pain. (Generally the major blood vessel in your groin is used for cardiac catheterization, but less commonly the arm may be used.) A short tube known as a sheath will be placed into the artery at the insertion site, through which a longer catheter will be introduced into the blood vessel. Your cardiologist will carefully maneuver the catheter through the blood vessel to your heart. You will not be able to feel the catheter as it moves through the arteries, but your doctor will be able to monitor the catheter’s progress on a digital screen next to your bed. Once the catheter reaches your heart, a liquid dye is injected through the catheter. This dye is a contrast fluid that allows your doctor to view your heart and coronary arteries on a special x-ray picture known as an angiogram.
If the type of plaque that responds best to atherectomy is present, the burr-tipped catheter is guided through a special catheter called a guiding catheter and carefully maneuvered to the blocked portion of your coronary artery. Your cardiologist monitors the movement of the atherectomy catheter on the digital screen at your bedside. Once this catheter reaches its proper position at the narrowed region of your coronary artery, your cardiologist will use the burr to shave away the plaque that is blocking your blood vessel. During the atherectomy procedure, you will hear a high-pitched sound (similar to a dentist drill) which is normal during this procedure. When the plaque is cleared from your artery, the catheters are removed and blood flow to your heart is restored. Your doctor may also wish to perform an angioplasty or implant a stent in this treated segment of your coronary artery immediately following the atherectomy to further deter the recurrence of a blockage (restenosis).
Once the procedure is complete you will be brought to a specialized, post-coronary intervention unit where you will continue to receive care from your team of cardiovascular specialists. You may experience some minor chest discomfort after the procedure, although it should diminish in severity within a few hours after the procedure. You will be asked to stay on bed-rest for six to 12 hours after the procedure. In routine cases patients can be discharged from the hospital the following day. Your cardiovascular care team will carefully review with you all discharge instructions, medications and restrictions. A follow-up visit with your primary care physician will be necessary after discharge, and on occasion, follow-up appointments may be scheduled with us at MHI. Your cardiologist will communicate the specifics of your hospitalization and treatment plan to your primary care doctor. Be sure to inform your doctor if you develop chest pain or experience any pain or increased swelling in or around your groin site. It is not uncommon to have bruising at the groin site following this procedure.
Other procedures for this sub-specialty
Specializing Cardiologists
- M. Nicholas Burke, MD
- Ivan J. Chavez, MD, FACC
- Bjorn P. Flygenring, MD, FACC
- Timothy D. Henry, MD, FACC
- John R. Lesser, MD, FACC
- Daniel Lips, MD, FACC
- James D. Madison, MD, FACC
- Michael R. Mooney, MD, FACC
- Wesley R. Pedersen, MD, FACC
- Anil K. Poulose, MD, FACC
- Jay H. Traverse, MD, FACC, FAHA
- Yale Wang, MD, FACC, FSCAI
|
- Find a Physician...
Practice Groups Physicians - Alden, Peter B.
- Almquist, Adrian K.
- Bae, Richard Y.
- Bernhardson, John
- Bobra, Shalini
- Burke, M. Nicholas
- Burns, Durand
- Chavez, Ivan J.
- Daniel, James A.
- Dirks, Timothy
- Eales, Frazier
- Flavin, Thomas F.
- Flygenring, Bjorn P.
- Furda, James
- Gornick, Charles
- Graber, John N.
- Graham, Kevin
- Grey, Elizabeth
- Harris, Kevin
- Hauser, Robert
- Henry, Timothy
- Hession, William
- Hirsch, Alan
- Houghland, Mark
- Hurrell, David
- Jay, Desmond
- Johnson, Randall
- Katsiyiannis, William
- Knickelbine, Thomas
- Kroshus, Timothy
- Kshettry, Vib
- Lawler, Casey
- Lee, Ken
- Lesser, John
- Lin, David
- Lips, Daniel
- Longe, Terrence
- Madison, James
- Melby, Daniel
- Mooney, Michael
- Nelson, Richard
- Olivari, Maria-Theresa
- Orlandi, Quirino
- Pagan-Carlo, Luis
- Pedersen, Wesley
- Poulose, Anil
- Rizvi, Adnan Z.
- Schwartz, Robert
- Sharkey, Scott
- Stokman, Peter
- Sullivan, Timothy M.
- Tang, Chuen
- Thiessen, Norma
- Traverse, Jay
- Tretinyak, Alexander S.
- Van Tassel, Robert
- Wang, Yale
Scheduling an AppointmentLearn how to make an appointment at MHI™.  |