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Coronary Atherectomy

Also known as: Directional Coronary Atherectomy (DCA)

Duration: About 1 to 2 hours

An atherectomy is a term for a group of procedures that use sharp blades to remove plaque (fat and calcium buildup) from clogged arteries.

A coronary atherectomy removes plaque from the coronary arteries. It is a minimally invasive procedure that follows the cardiac catheterization to improve blood flow to your heart muscle when severe calcium and/or fat builds up in the coronary arteries that an insertion and expansion of a stent is not possible.


Preparing for the procedure: 

Download Pre Procedure Instructions

How the procedure is performed: 

  • Firstly, a diagnostic cardiac catheterization is performed to check for any blocks in the coronary arteries. A catheter (a thin, long tube) is placed in either your arms, legs, or groin and is monitored by an x-ray camera until it reaches the coronaries.
  • A contrast dye is then infused so that the arteries can be seen. 
  • If an artery is blocked, you may require a coronary atherectomy to remove plaque from the clogged arteries.
    • Rotational Atherectomy – involves removing plaque by using a rotating catheter with a diamond-tipped blade
    • Orbital Atherectomy – involves using the Diamondback 360° Orbital Atherectomy System to remove the plaque with orbital motion
    • Laser Atherectomy – uses a laser-tipped catheter to treat complex blockages
  • Once the atherectomy is completed, your cardiologist will determine if a balloon angioplasty with or without stent placement would be required.

After the procedure: 

Download Post Procedure Instructions

Katsanos K, Spiliopoulos S, Reppas L, Karnabatidis D. Debulking Atherectomy in the Peripheral Arteries: Is There a Role and What is the Evidence? Cardiovasc Intervent Radiol. 2017;40(7):964-977. doi:10.1007/s00270-017-1649-6
Gupta T, Weinreich M, Greenberg M, Colombo A, Latib A. Rotational Atherectomy: A Contemporary Appraisal. Interv Cardiol. 2019;14(3):182-189. Published 2019 Nov 18. doi:10.15420/icr.2019.17.R1
Rawlins J, Din JN, Talwar S, O’Kane P. Coronary Intervention with the Excimer Laser: Review of the Technology and Outcome Data. Interv Cardiol. 2016;11(1):27-32. doi:10.15420/icr.2016:2:2