Atherectomy is a specialized procedure to remove plaque from the arteries caused by Peripheral Artery Disease. Peripheral Artery Disease, or PAD, affects approximately 12 million Americans today. PAD narrows arteries in the legs, limiting blood flow to your muscles. If you have symptoms, the most common include, painful cramping or aching in the hip, thigh or calf muscle; leg numbness or weakness; and, sores on toes, feet or legs that won’t heal.

Premier Radiology’s atherectomy technology is cutting edge; it is the first of its kind to remove significant amounts of plaque from the arteries. With this new technology, patients now have access to an advanced, proven treatment for plaque removal. Pain relief is usually immediate, bringing life-changing results

Who should have atherectomy?
Your doctor may recommend atherectomy if you show symptoms for Peripheral Artery Disease. Peripheral Artery Disease is usually caused by atherosclerosis, the same disease process that causes heart attacks and strokes. Diseases caused by atherosclerosis, such as PAD and Coronary Artery Disease, are the most common cause of death in the United States. Atherosclerosis usually begins early in life, progressing without symptoms, as plaque narrows the artery. Yet, by the time symptoms occur, atherosclerosis is usually advanced and represents a serious health concern.

Atherosclerosis is progressive, but it’s also preventable. You may be at risk if any of the following apply to you:

  • Smoking
  • High cholesterol
  • High blood pressure
  • Diabetes
  • Abdominal obesity
  • Stress
  • Not eating fruits and vegetables (recommended intake is 5 servings per day)
  • Excess alcohol intake (more than one drink for women, one or two drinks for men, per day)
  • Not exercising regularly (recommended is 30 minutes most days of the week)

How to prepare
Because atherectomy is a specialized, invasive procedure, some special preparation is needed. Please follow these guidelines before your exam:

  • Arrange for someone to drive you home after the procedure. Avoid driving for 24 hours after the exam.
  • Discontinue any of the following medications 5 days before your procedure: Plavix, Effient, Pletal, Ticlid, Trental, Coumadin, Brilinta, Xarelto or Pradaxa. Patients who have had a drug eluting cardiac stent within the past year should not stop Plavix or Effient.
  • Discontinue any of the following medicines 24 hours before your procedure: Lovenox, Fragmin, Normiflo, Orgaran, Innohep, Arixtra, Eliquis or Iprivask.
  • Take all other medications normally prior to your exam. Please take blood pressure medication the morning of your procedure. Please bring all your medications with you to your appointment. Do not hold heart or blood pressure medications.
  • If you are on insulin, take half of your dose the morning of the procedure. Do not take any oral diabetic medication the morning of the exam.
  • Do not eat solid foods 6 hours prior to your procedure. You may drink clear liquids until 2 hours before the procedure (no milk or creamer, no juice with pulp).
  • If you have had imaging done prior to your angiogram, please bring a copy with you.
  • On the morning of your procedure, please come to Premier Radiology Briarville 30 minutes prior to your appointment. We open at 7:30am.
  • Inform the staff of any allergies you have.
  • Please fill out and bring the documents and questionnaire about your current health status.
  • Bring a copy of the order for the procedure from your referring physician.
  • Bring a copy of your personal identification and health insurance information.

Download the atherectomy consultation and preparation form.

Procedure overview
Atherectomy is an exam to remove plaque buildup in the arteries caused by Peripheral Artery Disease. Atherectomy is accompanied by an arteriogram, or angiogram, to produce images of the vascular system; this is important to accurately diagnose before treatment. Before the exam, you will be given mild sedation through an IV inserted in the arm; your skin will be cleansed with antiseptic soap and numbed with local anesthetic. Then, an interventional radiologist will insert a small, tube-like camera called a catheter into an artery in the groin or arm. Once the catheter is inserted, contrast dye will be injected, which makes blood vessels visible on x-ray.

Understanding contrast
Atherectomy and arteriograms require a special dye, often called “contrast,” to produce images of the vascular system. Contrast can provide clearer images and allow better diagnostic capabilities. If you are given contrast, you might be asked not to eat or drink anything for 3-4 hours before the test. Contrast given through an IV might cause a metallic taste in the mouth, nausea and a warm flushing sensation. These sensations are normal and usually go away within a few minutes. Contrast typically does not cause symptoms; however, some mild symptoms, such as nausea, headache or itching. More complex side effects are rare; however, if you experience severe symptoms, inform your doctor immediately.

If you have kidney disease or diabetes, you should receive plenty of fluids before and after the test and be closely monitored for kidney problems. If you have diabetes or are on kidney dialysis, talk to your health care provider before the test about your risks

What to expect during atherectomy
After images are taken, an interventional radiologist will perform atherectomy. While you are still sedated, the interventional radiologist will move the catheter into an artery at the blocked vessel. The catheter will have a sharp blade on the end that the interventional radiologist will use to scrape away plaque blocking the artery. The process usually takes about two or three hours.

Once the atherectomy is complete, the catheter is removed. Patients are then moved to recovery and are typically able to walk within a few hours after the procedure and resume normal activity within one week. After your exam, you may need follow-up imaging, such as ultrasound, CT (computed tomography) or MRI (magnetic resonance imaging) exam.

After your procedure, please following these guidelines:

  • Drink plenty of clear (nonalcoholic) liquids, at least 8 oz. every hour
  • Resume your usual diet and any medications you routinely take (unless otherwise instructed by your doctor)
  • For the next 12 hours, attempt to keep the leg in which the catheter was placed as straight as possible
  • No driving, operating heavy machinery or making legal decisions for 24 hours following the exam
  • For several days after the procedure, avoid strenuous activities including vigorous exercise, lifting objects heavier than 10 pounds or excessive bending at the waist

Our interventional radiologists offer the full spectrum of care including pre-procedure consultation, post-procedure care and when necessary, hospital admission. All patients can schedule an office visit to consult with a radiologist to discuss treatment options prior to performing any procedure. To schedule an appointment please call our Briarville office at 615.986.6411.


Dr. Dan Wunder talks about peripheral arterial disease and Premier Radiology’s treatment options.


Dr. Dan Wunder discusses peripheral arterial disease on Channel 5’s Medical Mondays. Learn more about symptoms, diagnosis and treatment options.

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