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Sometimes, a coronary artery becomes thicker and less elastic due to the build-up of fatty deposits or plaque (PLAK) along the vessel lining. These plaque deposits, or atheromas (ath-eh-ROW-mahz), contain a spongy substance made up of cholesterol and other cellular materials that eventually harden and thicken. The atheroma site then may dangerously constrict the artery, causing insufficient blood supply to the heart and possibly leading to a heart attack if not treated. Fortunately, a fairly simple medical procedure called a coronary atherectomy (ath-eh-RECK-toe-mee) may be done to remove the atheroma without the risks and potential complications of major surgery. This technique involves inserting a thin, hollow, flexible tube or catheter (CATH-eh-ter) into a small incision in a leg or groin vein. The tip of the catheter is fitted with a special cutting tool called a rotoblator (ROE-toe-blay-tore), then gently guided up through the body to the atheroma site. Next, the rotoblator is used to cut away the thickened atheroma, restoring the arterial lining to its natural width. The resulting clean, smooth inner arterial surface may then be less likely to form future atheromas. The entire process is carefully monitored on an adjacent video screen, as a special X-ray camera films the catheter's progress. Generally, this procedure requires light sedation, a few days' hospital stay, and a brief amount of time for the incisions to heal. However, atherectomy is not designed to cure the underlying coronary artery disease. Heart disease medication may be prescribed, along with lifestyle changes that lessen the risk of future atheroma formation. Such changes might include eating a low-fat, low-cholesterol and low-sodium diet, maintaining a regular exercise program, and quitting smoking.
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