Atherectomy and Calcium-Modifying Devices

Atherectomy is the action of ablating (by means of cutting or vaporizing) intra-vascular atheroma. Endovascular devices to perform this technique have existed for four decades, with iterative improvements in their safety and efficacy. Although the technique is widely practiced, the data supporting its use remains of variable quality. The aim of atherectomy includes both debulking plaque and modifying the plaque left behind in order that it may respond better to subsequent angioplasty. The benefits of atherectomy might be more pronounced in in-stent restenosis and heavily calcified atheroma—although other non-ablative technologies to target calcified disease are also gaining credence.