Coronary Atherotomy

Patients

Your physician will determine the best course of action based on the following criteria: the type and location of plaque in your arteries, your specific anatomy, your medical history, and individual needs.

How the Technology Operates

The atherotomy balloon is a lot like an angioplasty balloon: it is guided to the target lesion, where the cardiologist inflates it to compress the plaque against the arterial walls. Unlike an angioplasty balloon, however, the atherotomy balloon has three or four microsurgical blades, known as "atherotomes," mounted onto the balloon surface. These atherotomes are intended to score (notch) the plaque and enable the balloon to dilate the lesion with less pressure than balloon angioplasty. The Flextome® Cutting Balloon® Device is an atherotomy device.

During the procedure, the physician will inflate the balloon, causing the atherotomes to emerge and make contact with the vessel wall. The atherotomes score the plaque and relieve resistance, allowing the plaque to compress against the vessel wall. The device is designed so the atherotomes retract back into the balloon as the balloon deflates.

The blades on the balloon are designed to prevent damage to the artery wall and are sheathed securely in the folds of the balloon until the balloon is inflated and again when it is deflated.

The Procedure

Your doctor will instruct you on how to prepare for the procedure prior to being admitted to the hospital. Your doctor may ask you to take aspirin and other prescribed medications for several days before the procedure. This is done to “thin” the blood to prevent blood clots from forming during the procedure. It is important to tell your doctor if you cannot take aspirin or have a history of bleeding problems. Your doctor also needs to know if you are taking any other medications or have drug allergies.

The procedure will be performed under local anesthetic so that you can talk to your physician and respond to instructions. Bring with you to the hospital any hearing aids, dentures, contacts, or eyeglasses that you may need to communicate effectively with the physician.

After the local anesthetic is administered to numb the small incision site in the groin, arm, or wrist, the physician will insert an introducer sheath into a blood vessel in the incision site and then feed the catheters into the blood stream to the affected portion of the coronary artery. Several injections of x-ray dye (called contrast) will be made so that the physician can choose the best "working angle" to view the blocked artery. A guide wire is threaded through the catheter until it extends past the area to be treated. At this point, the atherotomy balloon will be inserted through the catheter over the guide wire toward the blocked area. It will then be inflated within the lesion to score and compress the plaque, thereby increasing blood flow.

You may feel some discomfort when the sheath is inserted, and may also experience tightness or discomfort in the chest while the catheter is being guided to the lesion. If you feel any pain during the procedure, notify your physician immediately. The entire procedure is likely to be finished in less than two hours. Once the procedure has been completed, the doctor will take several "after" pictures. These will be compared to the "before" pictures to help evaluate the success of the procedure.

You will then be transferred to a recovery room where you will be carefully monitored and given any necessary medication. You will probably stay overnight in the hospital. The next day, you should be on your way home and you will probably be able to return to normal daily activities quickly.

Ask your physician for more information about the specific procedure which you will undergo. He or she will tell you how to prepare for it, what to expect, and what your recovery will be like.