Atherectomy is a minimally invasive procedure aimed at removing plaque accumulation from the inner walls of blood vessels. Plaque comprises fat, cholesterol, calcium, & other substances that can accumulate in the arteries over time. This buildup can lead to a medical condition known as atherosclerosis, which narrows or blocks the arteries, limiting blood flow to vital parts of the body, such as the heart, brain, and legs.
The primary goal of atherectomy is to restore proper blood flow, reduce the risk of complications like heart attacks or strokes, and relieve symptoms such as chest pain or leg cramps. This procedure is often recommended for unsuitable candidates for other treatments like angioplasty or stent placement due to the nature, location, or severity of their arterial blockages.
Atherectomy is commonly used to treat peripheral artery disease (PAD), coronary artery disease (CAD), or other vascular issues. It is performed by specialized doctors, typically under local anesthesia, with minimal recovery time compared to traditional open surgeries. This makes atherectomy a preferred option for many patients.
This blog will explore the causes of plaque buildup, the different types of atherectomy procedures available, the risks and benefits, and the costs involved. It will also discuss how atherectomy can help patients regain their quality of life. Understanding atherectomy can empower individuals to make informed decisions about their heart and vascular health.
Table of Contents
Atherectomy Meaning
Atherectomy is a medical process used to remove plaque buildup from the arteries. Plaque is a sticky, fatty substance made up of cholesterol, calcium, and other materials found in the blood. Over time, this plaque can build up on the inner walls of arteries, causing atherosclerosis, which causes the arteries to become narrow.
When arteries narrow, blood flow to vital organs and tissues is reduced, which can lead to symptoms like chest or leg pain or even more serious conditions like heart attacks or strokes. Atherectomy is performed to clear these blockages and restore normal blood flow.
Unlike other procedures such as angioplasty (which involves inflating a balloon to widen the artery) or stent placement (inserting a tiny mesh tube to keep the artery open), atherectomy removes the plaque from the artery. It uses a small catheter with a cutting or grinding device attached to its tip, which carefully shaves off or vaporizes the plaque.
This minimally invasive procedure is often used in cases where the plaque buildup is especially hard (calcified) or located in a tricky part of the artery that might not respond well to other treatments. Atherectomy can be used to treat conditions like peripheral artery disease (PAD), coronary artery disease (CAD), and blockages in other major blood vessels.
Causes Of Plaque Buildup (Atherosclerosis)
Plaque buildup, also known as atherosclerosis, is a gradual process that begins when the inner walls of the arteries are damaged. The following factors are the most common causes of this condition:
1. High Cholesterol Levels
- LDL (“Bad”) Cholesterol: Low-density lipoprotein cholesterol is a significant component of plaque. High levels of LDL in the blood can stick to the walls of arteries, contributing to plaque buildup.
- Low HDL (“Good”) Cholesterol: High-density lipoprotein helps remove excess cholesterol from the bloodstream. Low levels of HDL can increase the risk of plaque formation.
2. High Blood Pressure (Hypertension)
Chronic high blood pressure can damage the internal lining of the arteries, making it easier for cholesterol and other substances to stick to the walls. Over time, this leads to the formation of plaque.
3. Smoking
Smoking damages the lining of blood vessels & accelerates the buildup of plaque. It also reduces the oxygen level in the blood, forcing the heart to work harder and further straining the arteries.
4. Diabetes
Increased blood sugar levels can harm the blood vessels & increase the likelihood of plaque buildup. Diabetes is often associated with abnormal cholesterol levels, which further contributes to the risk of atherosclerosis.
5. Obesity
Being overweight or obese is related to high cholesterol, high blood pressure, and inflammation, all of which can increase the chance of plaque buildup in the arteries.
6. Poor Diet
Having foods high in saturated fats, trans fats, salt, & sugar can lead to high cholesterol and high blood pressure, contributing to the formation of plaque.
7. Sedentary Lifestyle
A lack of physical activity causes poor circulation, weight gain, and unhealthy cholesterol levels, all of which increase the risk of atherosclerosis.
8. Age
As people age, their arteries naturally lose elasticity and are more prone to damage, making them more susceptible to plaque buildup.
9. Genetic Factors
A family history of heart disease or atherosclerosis increases the likelihood of developing the condition.
10. Chronic Inflammation
Conditions like rheumatoid arthritis, lupus, or other autoimmune diseases can cause long-term inflammation, which damages the arteries and promotes plaque buildup.
Addressing these risk factors through a healthy lifestyle, medication, or medical interventions like atherectomy can reduce the risk of complications from plaque buildup, such as heart attacks, strokes, or reduced blood flow to the limbs.
Atherectomy Procedure
Atherectomy is a minimally invasive medical procedure to remove plaque buildup from the arteries. It is done using a small, flexible catheter equipped with a specialized tool to cut, grind, or vaporize the plaque. The objective is to restore blood flow & reduce symptoms caused by blocked arteries, such as pain, fatigue, or the risk of severe complications like heart attacks or strokes.
Different types of atherectomy procedures are based on the tool or method used to remove the plaque. These types are selected based on the blockage’s location, size, and hardness.
Types of Atherectomy Procedures
- Directional Atherectomy
- In this procedure, the catheter has a sharp blade or cutting device on one side.
- The doctor positions the blade against the plaque, shaves it away in small pieces, and then removes it from the artery.
- It is typically used for large, soft blockages and allows precise plaque removal.
- Best suited for: Peripheral arteries (e.g., in the legs).
- Rotational Atherectomy (Rotablator)
- This method uses a high-speed rotating burr or drill with a diamond coating to grind hardened plaque into tiny particles.
- These particles are small enough to pass through the bloodstream without causing blockages.
- It is particularly effective for calcified plaque, which is harder and more challenging to treat.
- Best suited for: Coronary arteries (e.g., arteries supplying the heart).
- Orbital Atherectomy
- Similar to rotational atherectomy, this method uses a diamond-coated device that rotates in an orbital (circular) motion.
- This technique can adjust its size to treat varying widths of arteries and effectively removes calcified plaques.
- It is also less likely to damage healthy artery walls.
- Best suited for: Coronary and peripheral arteries.
- Laser Atherectomy
- In this procedure, a catheter equipped with a laser is used to vaporize plaque.
- The laser emits pulses of ultraviolet light to break down plaque into microscopic particles.
- It is particularly effective for removing soft plaque, blood clots, or blockages caused by scar tissue after previous procedures.
- Best suited for: Complex blockages in coronary arteries.
- Excimer Laser Atherectomy (ELA)
- This is a more advanced laser technique that targets blockages with greater precision.
- It uses a laser catheter with excimer light energy to remove both soft and hard plaque, including scar tissue.
- Best suited for: Complicated or highly obstructive plaques.
Each of these procedures is performed under local anesthesia, often using X-ray imaging or ultrasound to guide the doctor in safely and effectively removing the plaque.
Atherectomy Cost In India
The cost of an atherectomy procedure in India varies depending on the hospital, the city, the type of procedure, and the severity of the condition. However, it is generally more affordable than in other countries, making India a popular destination for medical tourism.
Factors Affecting the Cost
- Type of atherectomy procedure (directional, rotational, laser, etc.).
- City or location of the hospital.
- The complexity of the blockage and the patient’s health condition.
- The type of hospital (government or private).
- Additional costs include pre-operative tests, medications, and hospital stay duration.
Estimated Cost Range in India
The cost of an atherectomy procedure in India typically ranges between ₹1,50,000 and ₹3,50,000.
City-Wise Cost Comparison
| City | Estimated Cost (INR) |
| Mumbai | ₹2,00,000 – ₹3,50,000 |
| Delhi | ₹1,80,000 – ₹3,20,000 |
| Bangalore | ₹2,00,000 – ₹3,00,000 |
| Chennai | ₹1,50,000 – ₹3,00,000 |
| Hyderabad | ₹1,60,000 – ₹3,10,000 |
| Kolkata | ₹1,50,000 – ₹2,80,000 |
| Pune | ₹1,70,000 – ₹3,00,000 |
| Ahmedabad | ₹1,50,000 – ₹2,70,000 |
| Jaipur | ₹1,50,000 – ₹2,50,000 |
| Lucknow | ₹1,40,000 – ₹2,60,000 |
Additional Costs to Consider
- Diagnostic Tests: Pre-procedure tests such as angiography, blood tests, and imaging scans can cost around ₹10,000 – ₹20,000.
- Hospital Stay: Depending on the hospital, staying for 1-2 days can add ₹10,000 – ₹25,000 to the total cost.
- Medications: Post-procedure medications for recovery may cost around ₹5,000 – ₹10,000.
Benefits Of Atherectomy
Atherectomy is a specialized procedure designed to remove plaque buildup from the arteries, and it offers several benefits, including:
1. Improved Blood Flow
By removing plaque, atherectomy restores normal blood flow to vital organs and tissues, reducing symptoms like chest pain, leg pain, and fatigue caused by blocked arteries.
2. Treatment of Hard Plaque
It is particularly effective in treating hardened or calcified plaque, which is often difficult to manage with other procedures like angioplasty.
3. Minimally Invasive
Atherectomy is a minimally invasive procedure, meaning it requires small incisions and results in shorter recovery times compared to open surgery.
4. Helps Avoid Open Surgery
In some cases, atherectomy can prevent the need for more invasive procedures like bypass surgery.
5. Versatility
The procedure can be performed on various arteries, including the heart (coronary arteries), legs (peripheral arteries), and other body parts.
6. Improves Success of Other Procedures
Atherectomy is often combined with stent placement or angioplasty. By clearing the plaque, it increases the effectiveness of these additional treatments.
7. Relief from Symptoms
Patients often experience immediate relief from signs like pain, cramping, and restricted mobility, allowing them to resume daily activities more comfortably.
Atherectomy Risks & Complications
While atherectomy is a safe and effective procedure, like any medical therapy, it does carry some risks and potential complications:
1. Bleeding or Bruising
Since the procedure involves inserting a catheter into the artery, there is a risk of bleeding or bruising at the insertion site.
2. Artery Damage
The cutting, grinding, or laser devices used in atherectomy can accidentally damage the artery walls, leading to complications like tearing or rupture.
3. Blood Clots
Removing plaque can sometimes cause small pieces to break off, which might form blood clots and travel to other body parts, potentially causing blockages.
4. Restenosis (Re-narrowing of the Artery)
In some cases, the artery may narrow again over time, requiring additional procedures.
5. Infection
Though rare, there is a small risk of infection at the catheter insertion site.
6. Reaction to Contrast Dye
A contrast dye is used during the procedure to guide the catheter. Some patients may have an allergic reaction or kidney-related side effects from the dye.
7. Heart Attack or Stroke (Rare)
In rare cases, complications during the procedure can lead to a heart attack or stroke.
Minimizing Risks
Doctors carefully evaluate a patient’s medical condition to minimize risks, and the procedure is performed under highly controlled conditions by experienced specialists.
Atherectomy Vs. Thrombectomy
Both atherectomy and thrombectomy are procedures to restore blood flow in blocked arteries, but they differ in terms of their purpose and the type of blockage they address.
| Feature | Atherectomy | Thrombectomy |
| Purpose | Removes plaque buildup from artery walls. | Removes blood clots from blocked arteries or veins. |
| Cause of Blockage | Caused by atherosclerosis (plaque). | Caused by blood clots (thrombus). |
| Technique | Uses cutting, grinding, or laser devices. | Suction or mechanical devices are used to remove clots. |
| Common Use Cases | Peripheral artery disease, coronary artery disease. | Deep vein thrombosis, pulmonary embolism, or acute stroke. |
| Materials Removed | Fatty deposits, calcified plaque. | Fresh or old blood clots. |
| Combination with Other Procedures | Often combined with stents or angioplasty. | It may be combined with medication (thrombolytics). |
In summary, atherectomy is better suited for clearing hard plaque, while thrombectomy focuses on removing blood clots. Both procedures are critical in treating vascular blockages depending on the underlying cause.
Conclusion
Atherectomy is an advanced medical procedure that has helped countless patients regain normal blood flow and reduce symptoms caused by arterial blockages. It is particularly effective in treating hardened or complex plaques that are difficult to manage with other methods. However, the procedure has risks that should be carefully considered & discussed with a medical professional.
Unfortunately, the cost of atherectomy in India can be pretty high, ranging from ₹1,50,000 to ₹3,50,000, depending on the hospital and city. For many patients, this cost is a significant financial burden.
Crowdfunding platforms provide a practical solution for patients facing high medical expenses. By sharing your story on these platforms, friends, family, and even strangers can contribute small amounts that add up to cover the cost of life-saving procedures like atherectomy. These platforms have helped thousands of people in India access essential medical care without falling into debt.
FAQs About Atherectomy
1. What Are the Benefits of Atherectomy?
Atherectomy improves blood flow by removing plaque buildup in arteries, relieving symptoms like pain and restricted mobility. It is effective for hardened plaque and can enhance the success of other procedures like stent placement.
2. Is Atherectomy Safe?
Atherectomy is generally safe when performed by experienced specialists. However, it does carry some risks, such as bleeding, artery damage, or restenosis. Your physician will examine these risks with you before the procedure.
3. How Is Atherectomy Different from Angioplasty?
Atherectomy removes plaque from the artery walls, while angioplasty uses a balloon to push the plaque aside and widen the artery. Atherectomy is preferred for harder or calcified plaque.
4. What Is the Recovery Time for Atherectomy?
Recovery from atherectomy is usually quick, with most patients returning to routine activities within a few days. However, the exact recovery time depends on the individual’s health and the complexity of the procedure.
5. How Much Does Atherectomy Cost in India?
The cost of atherectomy in India typically ranges between ₹1,50,000 and ₹3,50,000. Costs vary depending on the hospital, city, and the type of procedure used.
