Coronary Rotablation: Treating Calcified Coronary Arteries
Coronary Rotablation, also known as Rotational Atherectomy, is a specialized procedure used to break down heavily calcified plaques in the coronary arteries. This technique is employed when traditional balloon angioplasty fails to effectively open a blocked artery due to severe calcification.
Why is Rotablation Needed?
In some cases of coronary artery disease (CAD), fatty plaques harden due to calcium buildup, making them difficult to expand with a standard balloon angioplasty. Rotablation is used to modify or debulk these hardened plaques, allowing for stent placement and better blood flow to the heart.
How is Rotablation Performed?
- Catheter Insertion – A catheter is inserted through the radial (wrist) or femoral (groin) artery and guided to the narrowed coronary artery.
- Rotablator Device – A diamond-tipped, high-speed rotating burr is used to grind down the calcified plaque into tiny particles (microdebris), which are safely washed away by the bloodstream.
- Balloon Angioplasty & Stenting – After modifying the plaque, a balloon is inflated to further open the artery, and a stent is placed to keep it open.
When is Rotablation Recommended?
- When severe calcification prevents the proper expansion of a stent or balloon
- In patients with chronic stable angina who are unresponsive to medications
- In cases where traditional angioplasty alone is not effective
Benefits of Rotablation
- Improves artery flexibility and allows for successful stent placement
- Reduces restenosis (re-narrowing) rates in calcified arteries
- Enhances blood flow and reduces symptoms like chest pain (angina)
Risks and Considerations
While generally safe, potential risks include:
- Vessel perforation (rare but serious)
- Slow blood flow due to excessive plaque modification
- Temporary chest discomfort during the procedure
Coronary Rotablation is a highly effective technique for treating calcified coronary arteries when standard angioplasty is insufficient. With advanced interventional techniques, cardiologists can successfully restore blood flow and improve patient outcomes.