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Coronary Atherectomy Atherectomy means removing the obstructive plaque ("blockage"). There are three techniques available: 1) Extractional atherectomy, which consists of slowly rotating blades and a suction mechanism. This procedure is used for bypasses or blockages which may contain large blood clots. 2) Directional atherectomy, which uses a catheter that has a side-window on its tip and half a balloon in the other side. A rotating blade is advanced and "shaves off" the blockage. The little pieces are collected in the nose tip of the catheter and removed. This procedure is good for large arteries with soft blockages. 3) Rotational atherectomy ("rotablator") which is the newest available. It has an olive-shaped tip that rotates at high speed and literally drills the blockage into microscopic particles that dissolve in the circulating blood. This is
a good option for calcified and hard blockages. The interventional cardiologists
at the Heart Institute are experts in these techniques.
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