Three views of the inside of an artery with a device and catheter removing a buildup of plaque.

An atherectomy is a surgical procedure to remove a buildup of fat, cholesterol, and other substances (plaque) from the inside of an artery. Arteries are the blood vessels that carry blood from the heart to the rest of the body. A buildup of plaque in the arteries can block blood flow. In this procedure, plaque is removed from an artery using a device at the end of a long, thin tube (catheter). A stent, which is a small mesh tube, may be placed in the artery to prevent it from getting blocked again.

You may have this procedure to remove plaque from the arteries of your heart (coronary arteries). You can also have this procedure to clear arteries in other parts of your body, such as the arteries that provide blood to your legs or kidneys.

Tell a health care provider about:

  • Any allergies you have.

  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.

  • Any problems you or family members have had with anesthetic medicines.

  • Any bleeding problems you have.

  • Any surgeries you have had.

  • Any medical conditions you have.

  • Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

  • Infection.

  • Bleeding.

  • Allergic reactions to medicines or dyes.

  • Damage to nearby structures or organs.

  • Inability to open the blocked artery.

  • Tear in the artery or artery rupture.

  • Heart attack (if the procedure is done on a heart artery).

  • Amputation (if the procedure is done on a leg artery).

  • Return of the blockage or clotting.

  • A blood clot that can lead to a stroke.

What happens before the procedure?

Medicines

Ask your health care provider about:

  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.

  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.

  • Taking over-the-counter medicines, vitamins, herbs, and supplements.

General instructions

  • Follow instructions from your health care provider about eating or drinking restrictions.

  • Plan to have a responsible adult take you home from the hospital or clinic.

  • Plan to have a responsible adult care for you for the time you are told after you leave the hospital or clinic. This is important.

  • Ask your health care provider what steps will be taken to help prevent infection. These steps may include:

    • Removing hair from your groin area.

    • Washing skin with a germ-killing soap.

    • Taking antibiotic medicine.

What happens during the procedure?

  • An IV will be inserted into one of your veins.

  • Sticky patches (electrodes) will be placed on your chest to monitor your heart rhythm.

  • You will be given one or more of the following:

    • A medicine to help you relax (sedative).

    • A medicine to numb the groin or wrist area (local anesthetic).

  • Your health care provider will make a small incision in your groin area or wrist and identify the needed artery.

  • A catheter will be put into the artery and guided to the location of the plaque. Your health care provider will use X-ray images to guide the catheter to the right spot.

  • Dye will be injected into the artery after the catheter is in the correct position.

  • Your health care provider will use an instrument that is inserted through the catheter to cut away pieces of plaque. The pieces will be stored in part of the catheter so they can be removed.

  • A stent may be put in place to help keep your artery open.

  • The catheter will be removed.

  • The incision will be closed and covered with a certain type of bandage (pressure dressing).

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

  • Your blood pressure, heart rate, heart rhythm, breathing rate, and blood oxygen level will be monitored until you leave the hospital or clinic.

  • After several hours, you will be encouraged to get up and walk around.

  • If you were given a sedative during the procedure, it can affect you for several hours. Do not drive or operate machinery until your health care provider says that it is safe.

Summary

  • An atherectomy is a surgical procedure to remove a buildup of fat, cholesterol, and other substances (plaque) from the inside of an artery.

  • In this procedure, plaque is removed from an artery using a device at the end of a long, thin tube (catheter). A small mesh tube (stent) may be placed in the artery to prevent it from getting blocked again.

  • Before the procedure, ask your health care provider about changing or stopping your regular medicines. Also follow any instructions about eating or drinking restrictions.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.