Editing Angioplasty (section)

== Adjunctive therapy ==
Rotational [[Atherectomy]], or "rotablation", is a technique used to treat heavily calcified coronary artery lesions by ablating plaque with a diamond-encrusted burr rotating at high speeds. It improve vessel lumens for balloon dilation and stent implantation. While effective for complex cases like [[Calcified|calcification]] of nodules and tortuous vessels, its use is limited by procedural complexity, lack of training, and a need for specialized equipment. High procedural success rates are reported, especially with skilled operators, but careful patient selection is crucial to minimize complications. Studies show RA's efficacy in comparison to alternative techniques, particularly for challenging lesions.

[[Atherectomy]] is an adjunctive therapy used for lesion preparation of calcified plaque before percutaneous coronary intervention. The goal of lesion preparation with atherectomy is to modify calcified plaque, which changes the lesion compliance and allows for adequate balloon and stent expansion in segments with heavily calcified lesions.<ref>{{cite journal | vauthors = Khattak S, Sharma H, Khan SQ | title = Atherectomy Techniques: Rotablation, Orbital and Laser | journal = Interventional Cardiology | volume = 19 | pages = e21 | date = 2024-10-31 | pmid = 39569386 | pmc = 11577869 | doi = 10.15420/icr.2024.16 }}</ref>

=== Atherectomy techniques ===
====Rotational Atherectomy====

Rotational atherectomy modifies plaque through rotational [[ablation]] using a diamond-tipped burr that spins concentrically on the wire. This technique is particularly useful for heavily calcified lesions that are resistant to balloon angioplasty.

==== Orbital Atherectomy ====
Orbital atherectomy employs an eccentrically mounted diamond-coated crown that orbits within the vessel, sanding down calcified deposits. This method has a reduced risk of burr entrapment compared to rotational atherectomy.

====Excimer Laser Coronary Angioplasty====

Excimer laser coronary angioplasty uses pulsatile ultraviolet laser energy to precisely ablate plaque tissue. It is effective in modifying undilatable and uncrossable lesions, facilitating subsequent balloon angioplasty and stent deployment.

Atherectomy is a valuable [[adjunctive therapy]] for patients with [[coronary artery disease]], particularly those with severely calcified lesions where traditional balloon angioplasty and [[stenting]] may be insufficient. Its success depends on the selection of appropriate devices and the operator’s expertise in managing the technical nuances to minimize complications. Studies have demonstrated that atherectomy can enhance procedural success rates and long-term outcomes in complex cases. However, further research and standardized protocols are needed to address challenges and expand its clinical applications effectively.

{{Main|Atherectomy}}