Peripheral arterial disease (PAD) is a circulatory system condition caused by the gradual buildup of cholesterol plaque in the arteries. Though PAD can occur anywhere in the endovascular system, it’s mostly found in the legs. One treatment option of PAD is an atherectomy procedure, in which a catheter is inserted via a minimally invasive incision in the artery.
The atherectomy procedure has evolved with cutting-edge advances, including orbital, rotational, and diamond-coated surfaces technology, as well as a laser to remove or modify plaque from a clogged blood vessel. It’s particularly useful for treating arteries or blood vessels that not easily treated with stents. Dr. Donikyan explains the atherectomy procedure and how it can treat PAD.
What is Atherectomy Procedure?
An atherectomy procedure is performed when we identify there is an area of narrowing or obstruction in the artery in your leg due to plaque that has developed. The term atherectomy describes the action of actually going into removing that plaque. There are lasers that we can use, or there’s an orbital device that spins around and shaves down the plaque. The procedure debulks the plaque. If we later use an angioplasty balloon, our results are much better. The result of the atherectomy procedure is a wider channel that reopens the areas that are blocked or narrowed.
Why Would a Doctor Choose an Atherectomy Procedure for a PAD Treatment?
Once we’ve decided that a patient is going to undergo an angiogram, we use images to determine the extent of any blockages that might be present in the lower extremities. We assess what type of plaque is present, how much plaque has built up, and whether or not this is calcified. The more plaque that is built up, the more likely we would decide to use an atherectomy device, shaving away the plaque, in order to create a channel. Our balloons and potential stents will be more effective once we’ve debulked some of the plaque.
There are instances where there is not much plaque, but you still have a narrowing, causing issues with wound healing or the ability to walk. If there’s not a lot of plaque burden, then angioplasty by itself will be sufficiently effective in opening up those narrow areas. Depending on what we see on the initial diagnostic images that we take, we will make a decision whether or not to use an atherectomy and shave away those plaques or if we can just go straight to angioplasty or a possible stent placement if needed.
Does an Atherectomy Procedure Have to be Performed in a Hospital?
Atherectomy procedures do not have to be performed in the hospital. We do them in our centers in an outpatient setting. We do use sedation as you would use for colonoscopy, similar to twilight anesthesia. The procedures take anywhere from 45-minutes to possibly two hours, depending on the extent of what we have to do. The recovery time is about an hour and a half afterward, sometimes a bit longer. It is a same-day procedure, we like to see atherectomy patients early in the morning so they can go home early in the afternoon. There’s no need to use the hospital for these procedures anymore.
How Long Does it Take to Recover from an Atherectomy?
The recovery process for atherectomy, in terms of the immediate post-procedure recovery, is usually a couple of hours. The procedure can take upwards of an hour, to two hours, depending on how extensive the lesion is – an increase in the number and severity of blockages or complete occlusions tends to lead to a longer procedure. Once we complete the procedure and use a closure device to help close the hole that we’ve made in the artery, you are usually able to walk within an hour and a half post-procedure. We ask that you take it easy for about 24 to 48 hours. This means no heavy lifting or intense physical activity, but normal walking is encouraged within 24 hours and there are no real restrictions after that.
Request a Consultation with Dr. Donikyan
If you or someone you know may be suffering from peripheral arterial disease, it is critically important to be evaluated by a medical professional. The American Endovascular affiliated team of physicians is at the forefront of the detection and treatment of PAD. Request a consultation with Dr. Chris Donikyan today at Fishkill Endovascular to learn more about our PAD treatments.