Coronary atherectomy is a catheter-based procedure used to treat  coronary artery disease (CAD), a chronic disease characterized by the “hardening” (atherosclerosis) of the coronary arteries. During an atherectomy, a physician guides a long, thin tube called a catheter into the blocked coronary arteries. This catheter has been equipped with special devices that remove some of the fatty plaque inside the blocked arteries.

An atherectomy may be performed before other catheter-based techniques, such as balloon angioplasty and/or stenting. However, as angioplasty and stent technology steadily improve, the use of coronary atherectomy is declining. Currently, atherectomy is used in only about 3 percent of patients undergoing coronary intervention. Its use is usually reserved for patients who have very hard or heavily calcified plaque, or who have unusual lesions inside their coronary arteries.

An atherectomy is performed in a catheterization laboratory. As with balloon angioplasty and other catheter procedures, patients are numbed with a local anesthetic at the site where the physician will insert the catheter. This is usually the groin area, although physicians sometimes use the wrist or arm.

After inserting the catheter, the physician guides it up a blood vessel to the heart. Once the catheter is in place, the physician cuts away plaque using either a sharp blade or a rotating device (such as a burr) attached to the tip of the catheter.

Following the procedure, the catheter is removed and the patient is allowed to recover. Most patients can go home after about 24 hours.