Rotablator Procedures (Coronary Atherectomy)

During a coronary atherectomy procedure, the cardiologist uses a catheter with a precision, rotating blade or burr at its tip to shave the plaque accumulation and open the blockage. Because there is still plaque after this procedure, the doctor inserts a balloon catheter to compress the remaining plaque against the artery wall (angioplasty procedure).

There are several variants on the atherectomy (rotoblader) procedure. These procedures are named by the type of cutting device that is at the tip of the catheter.

Rotational Atherectomy

A small burr with diamond cutting chips at the tip of the catheter rapidly rotates to grind the plaque. The particles cut by this device are smaller than even the red blood cells in the bloodstream. Generally, they cause no problems by floating in the bloodstream.

Directional Coronary Atherectomy (DCA)

A rotating blade at the tip of the catheter shaves the plaque. Small particles are collected at the tip of the catheter and then extracted when the device is removed.

Extraction Atherectomy

A rotating blade at the tip of the catheter shaves the plaque. The small particles are vacuumed into the catheter and removed from the body. This device is larger than other units and works only on soft plaque. For that reason, it is limited to removing plaque from bypass grafts.

Desired Result - Patent (Open) Artery

The goal is to open the blockage so blood may freely flow to the regions of the heart muscle served by the coronary artery.