Rotablation, also known as rotational atherectomy, is a procedure used in the treatment of coronary artery disease (CAD). It is a technique employed to remove plaque buildup from within the coronary arteries to improve blood flow to the heart muscle. Here’s an overview of how rotablation works and its role in CAD treatment:
- Procedure: Rotablation involves the use of a specialized catheter with a tiny, diamond-coated burr at its tip. The catheter is inserted into the affected coronary artery through a small incision, typically in the groin area. Using a rotating motion, the burr spins at high speeds and grinds away calcified plaque deposits within the artery.
- Plaque removal: The rotational movement of the burr allows it to break up and pulverize the hardened plaque, reducing the obstruction in the coronary artery. The microscopic particles resulting from the plaque removal are carried away through the bloodstream and eventually filtered out by the liver and spleen.
- Benefits: Rotablation can be beneficial in cases where the plaque within the coronary arteries is particularly dense or calcified, making it challenging to treat with other methods such as angioplasty or stenting. By removing the plaque, rotablation helps restore blood flow, relieve symptoms of CAD (such as chest pain), and potentially improve overall heart function.
- Stenting: After the plaque has been sufficiently treated with rotablation, additional procedures such as balloon angioplasty and stenting may be performed. This involves inserting a balloon catheter into the artery to widen it and placing a stent (a small mesh tube) to keep the artery open and maintain adequate blood flow.
- Considerations: Rotablation is not suitable for all cases of CAD. It is typically used in specific situations where the plaque is heavily calcified or when conventional treatments are less effective. The decision to perform rotablation is made by a skilled cardiologist after careful evaluation of the patient’s condition and imaging tests.
- Risks: Like any medical procedure, rotablation carries certain risks. Possible complications may include vessel damage, dissection (tear) of the artery, embolization (plaque particles blocking smaller blood vessels), irregular heart rhythms, and bleeding at the catheter insertion site. However, with experienced operators and appropriate patient selection, the risks can be minimized.
It’s important to note that the specific treatment approach for CAD, including the use of rotablation, will vary depending on individual patient factors and the extent and characteristics of the coronary artery disease. A cardiologist will evaluate each case and recommend the most appropriate treatment strategy to achieve optimal outcomes.