Atherectomy

Atherosclerosis is hardening of the arteries. Plaque buildup blocks blood flow to your heart. This can cause chest pain, shortness of breath, or a heart attack.

University of Iowa Heart and Vascular Center interventional cardiologists use atherectomy to treat atherosclerosis.

Atherectomy is a minimally invasive procedure that removes or shrinks blockages. It can relieve your symptoms and lower your risk for conditions like heart attack or stroke.

Our approach to atherectomy

During an atherectomy, your doctor clears blockages using a device inserted into your artery through a thin tube called a catheter.

When you’re choosing where to have an atherectomy, experience matters.

  • We’ve performed thousands of atherectomies, including the most advanced procedures. Smaller hospitals send their most challenging cases to us.
  • Our expertise, state-of-the-art equipment, and range of treatment options are unmatched in Iowa.
  • Most medical centers offer one or two types of atherectomy. We offer four.

We also offer alternatives if this procedure isn’t right for you. Your care team of cardiologistsvascular surgeonsheart surgeons, imaging specialists, and other experts collaborates to create your customized treatment plan.

Types or atherectomy

Our cardiac catheterization labs are equipped with a full range of atherectomy devices.

Your cardiologist will choose the one that will work best, based on factors like the size of the blood vessel that’s blocked, the amount of calcium present in the blockage, and other considerations.

  • Rotational atherectomy breaks up plaque with a rotating instrument that’s like a tiny drill. 
  • Orbital atherectomy uses a device that can spin at different speeds and different distances from its fixed center point.
  • Laser atherectomy uses high-energy light to vaporize plaque.
  • Intravascular lithotripsy uses ultrasound shock waves to break up plaque. It was approved by the FDA in 2021. We’re the first center in Iowa to perform the procedure.

What to expect when you have an atherectomy

During your atherectomy

An atherectomy usually takes one to three hours. Here’s what you can expect during that time:  

  • You’ll be sedated so that you’re relaxed but awake.
  • Your cardiologist will make a small incision on the inside of your upper leg.
  • A thin, flexible tube called a catheter is inserted through the incision into an artery and threaded into your heart.
  • The atherectomy device is inserted through the catheter to remove or shift the calcifications, and a small mesh tube called a stent is placed to prop open your artery so blood can flow through. 

After your atherectomy

Once your procedure is finished, you’ll remain in the recovery room for a few hours of monitoring. After that, here’s what you can expect:

  • Some people stay in the hospital overnight after the procedure, but many can go home the same day.
  • You’re likely to feel improvement right away if you’ve been having chest pain, fatigue, or shortness of breath.
  • You’ll need to limit your activity for several days. In about a week, you can get back to normal activities like work and moderate exercise.
  • Your cardiologist may prescribe medication to lower your cholesterol and control your blood sugar and blood pressure.
  • Depending on your condition and overall health, you may have follow-up tests, like an exercise stress test. And your cardiologist may recommend cardiac rehabilitation to help you recover.

Alternatives to atherectomy

If your cardiologist decides that atherectomy won’t work for your atherosclerosis, you may need to have a different kind of procedure. Depending on your diagnosis and overall health, some options could include:

  • Angioplasty and a stent
  • Bypass surgery
  • Endarterectomy, a surgery to remove plaque from blood vessels that supply the brain
  • Thrombectomy, a minimally invasive procedure to remove blood clots

Has your doctor recommended that you be evaluated for atherectomy?

When you call the UI Heart and Vascular Center, we'll connect you with an experienced specialist.

Care Team

Cardiologist, Internal Medicine