Atherectomy
Learn about atherectomy in Singapore, a minimally invasive treatment that removes or modifies plaque in narrowed arteries provided by Dr. Manish Taneja from the Supreme Vascular and Interventional Clinic. Understand how it works, who may benefit, risks and recovery.
Atherectomy in Singapore
Minimally Invasive Treatment for Selected Dural Arteriovenous Fistulas
Atherectomy is a minimally invasive endovascular procedure used to remove or modify plaque that has built up inside a narrowed artery. Plaque build-up can cause arteries to become narrower and restrict blood flow. In some patients, particularly those with heavily calcified or complex arterial disease, specialised plaque modification may be considered as part of the treatment strategy.
During atherectomy, a specialised catheter is guided through the blood vessel to the area of narrowing. The device is then used to remove, shave, sand or modify plaque within the artery, depending on the atherectomy technology being used.
Atherectomy may be performed on its own in selected circumstances or combined with angioplasty, drug-coated balloon treatment or stenting.
At the Supreme Vascular and Interventional Clinic, vascular treatment is led by Dr. Manish Taneja, a dual-trained neurointerventional and peripheral vascular intervention specialist.
With expertise spanning the brain and body, our specialized clinic provides specialist-led vascular assessment, minimally invasive treatment and continuity of care under one roof.
Treatment Overview
| Treatment Type | Minimally invasive endovascular procedure |
|---|---|
| Also Known As | Plaque removal, plaque modification |
| Used for | Selected narrowed or heavily calcified arteries |
| Common condition treated | Peripheral arterial disease |
| Treatment goal | Remove or modify plaque and improve blood flow |
| How it works | A specialised catheter is used to remove or modify plaque inside the artery |
| Procedure Access | Catheter inserted through the wrist or groin |
| Anaesthesia | Depends on the individual procedure and clinical circumstances |
| Follow-Up | Clinical review and vascular imaging may be recommended |
| Performed By | Dr Manish Taneja, dual-trained neurointerventional and peripheral vascular intervention specialist |
What Is Atherectomy?
Atherectomy is a minimally invasive treatment that removes or modifies plaque inside a narrowed artery.
Plaque is made up of substances such as cholesterol, fatty deposits and calcium that can accumulate within the artery wall. As plaque builds up, the artery can become progressively narrower, restricting blood flow to the tissues supplied by that vessel.
Some arterial blockages are particularly difficult to treat because the plaque is extensive, hard or heavily calcified. Atherectomy uses a specialised catheter-based device to remove or modify plaque within the artery. This can create more space within the vessel and may help prepare the artery for additional treatment.
Atherectomy is most commonly associated with treatment of peripheral arterial disease (PAD), particularly when plaque is complex or heavily calcified.
How Does Atherectomy Work?
Removing or Modifying Plaque Inside the Artery
Before treatment, vascular imaging is used to identify the location, severity and characteristics of the arterial narrowing. A thin catheter is guided through the blood vessel towards the affected artery.
A specialised atherectomy device is then positioned within the narrowed section. Depending on the technology used, the device may cut, shave, sand or otherwise modify the plaque inside the artery.
The treated vessel is then assessed using imaging to determine the improvement in blood flow and whether additional treatment is required. Atherectomy may be followed by angioplasty or another endovascular treatment when appropriate.
Key Difference: Angioplasty primarily uses a balloon to widen a narrowed artery, while atherectomy uses a specialised device to remove or modify plaque within the artery.
When Might Atherectomy Be Recommended?
Atherectomy may be considered for selected patients with significant arterial narrowing, particularly when plaque is extensive, complex or heavily calcified.
Your specialist will consider:
- The location of the arterial narrowing
- The severity of the blockage
- The amount and type of plaque
- Whether the artery is heavily calcified
- Your symptoms
- The underlying vascular condition
- Your previous treatments
- Your overall health
- Whether angioplasty or another treatment may be more appropriate
Not every patient with arterial narrowing requires atherectomy.
Depending on the condition, treatment may instead involve medication, lifestyle and risk-factor management, angioplasty, a drug-coated balloon, stenting or another vascular procedure.
Atherectomy vs Angioplasty
Understanding the Difference
Atherectomy and angioplasty are both minimally invasive endovascular treatments, but they work differently.
In some patients, atherectomy and angioplasty are used together. Atherectomy can modify the plaque first, allowing subsequent balloon treatment to be performed more effectively in selected cases.
| Atherectomy | Angioplasty |
|---|---|
| Removes or modifies plaque within the artery | Uses a balloon to widen the narrowed artery |
| Particularly useful for selected complex or calcified plaque | Used to widen selected narrowed or blocked vessels |
| Uses a specialised plaque-modifying device | Uses a balloon catheter |
| May prepare the artery for another treatment | May be performed alone or followed by stenting |
| Can be combined with angioplasty | Can be combined with atherectomy or other treatments |
Atherectomy and Heavily Calcified Arteries
Why Plaque Characteristics Matter
Some arterial narrowing contains substantial calcium, making the plaque particularly hard.
Heavily calcified arteries may be more challenging to treat with balloon angioplasty alone because the vessel may not expand adequately.
In selected patients, atherectomy can be used to modify the calcified plaque before angioplasty or another endovascular treatment. The goal is to improve the vessel's ability to respond to treatment while reducing the severity of the narrowing.
Whether atherectomy is appropriate depends on detailed vascular imaging and the characteristics of the individual artery.
Potential Benefits of Atherectomy
Minimally Invasive Plaque Modification
For appropriately selected patients, atherectomy may provide several potential benefits.
Minimally Invasive Approach
Treatment is performed through a catheter rather than open vascular surgery.
Modifies Plaque Within the Artery
Atherectomy directly targets plaque responsible for the arterial narrowing.
Can Address Complex Plaque
Specialised atherectomy techniques may be considered for selected arteries containing extensive or heavily calcified plaque.
Improve Blood Flow
Reducing the obstruction within the artery can help create more space for blood to flow.
Can Prepare the Artery for Further Treatment
Atherectomy may be used before angioplasty, drug-coated balloon treatment or stenting in selected patients.
It is important to remember: Every artery is different. The potential benefits of atherectomy depend on the location, severity and characteristics of the plaque and the patient's overall vascular health.
What Are the Potential Risks and Limitations?
Understanding the Risks of Atherectomy
Atherectomy is a specialised vascular procedure and carries potential risks.
Potential risks may include:
- Bleeding or bruising at the catheter access site
- Plaque or debris moving downstream
- Re-narrowing of the treated artery
- Infection
- Reaction to contrast dye
- Need for additional treatment
The risks vary depending on the artery being treated, the severity and characteristics of the plaque and the complexity of the procedure.
Your specialist will explain the potential benefits, risks and alternative treatment options before recommending atherectomy.
Recovery After DAVF Embolisation
What Can You Expect After Treatment?
Following atherectomy, you will be monitored while the treated artery and catheter access site are assessed. Your recovery depends on the location and complexity of the treatment and your overall health.
Your specialist will provide personalised advice regarding:
- Caring for the catheter access site
- Prescribed medications
- Physical activity
- Returning to normal activities
- Follow-up appointments
- Vascular imaging where required
- Managing cardiovascular risk factors
Long-term management of the underlying vascular disease remains important because atherectomy treats the arterial narrowing but does not remove the underlying risk factors that contribute to plaque formation.
Your Atherectomy Treatment Journey
| Step | Stage | Description |
|---|---|---|
| 1 | Specialist Vascular Assessment | Review your symptoms, medical history and previous vascular investigations. |
| 2 | Detailed Vascular Imaging | Assess the location, severity and characteristics of the arterial plaque. |
| 3 | Individualised Treatment Planning | Determine whether atherectomy, angioplasty or another treatment is most appropriate. |
| 4 | Catheter-Based Atherectomy | Use a specialised device to remove or modify plaque within the narrowed artery. |
| 5 | Blood Flow Assessment | Use vascular imaging to assess the treated artery and treatment result. |
| 6 | Additional Treatment If Required | Perform angioplasty, drug-coated balloon treatment or stenting when clinically appropriate. |
| 7 | Recovery & Follow-Up | Continue specialist monitoring and management of underlying vascular risk factors. |
Why Choose the Supreme Vascular and Interventional Clinic for Atherectomy?
Specialist Brain-to-Body Vascular Expertise Under One Roof
Complex arterial disease requires careful understanding of vascular anatomy, blood flow and the different minimally invasive treatment options available.
At the Supreme Vascular and Interventional Clinic, care is led by Dr. Manish Taneja, a dual-trained neurointerventional and peripheral vascular intervention specialist.
Brain-to-Body Vascular Perspective
Specialist expertise spans vascular conditions affecting both the brain and wider circulation.
Personalised Treatment Planning
Treatment is selected according to the location, severity and characteristics of your arterial disease.
Minimally Invasive Treatment
Where appropriate, catheter-based treatment can address complex arterial narrowing without open vascular surgery.
Advanced Imaging
Detailed vascular imaging helps assess plaque characteristics and guide precise endovascular treatment.
Continuum of Care
From specialist assessment and treatment planning through follow-up and further imaging, the Supreme Vascular and Interventional Clinic provides continuity of specialist care under one roof.
Frequently Asked Questions About Atherectomy
Is atherectomy the same as angioplasty?
No. Atherectomy removes or modifies plaque within the artery, while angioplasty uses a balloon to widen the narrowed vessel.
Can atherectomy and angioplasty be performed together?
Yes. In selected patients, atherectomy may be performed before angioplasty to modify plaque and prepare the artery for balloon treatment.
Is atherectomy minimally invasive?
Yes. Atherectomy is performed through a catheter inserted into the blood vessels rather than through open vascular surgery.
What happens after atherectomy?
Patients are monitored after treatment and receive personalised advice regarding medication, activity, follow-up and management of vascular risk factors.
Can an artery narrow again after atherectomy?
Yes. Re-narrowing can occur after treatment, which is why follow-up and management of the underlying vascular disease are important.
Specialist Assessment for Atherectomy in Singapore
The most appropriate treatment for arterial narrowing depends on the location, severity and characteristics of the plaque, as well as your symptoms and overall health. At the Supreme Vascular and Interventional Clinic, Dr. Manish Taneja provides specialist vascular assessment, advanced imaging review and personalised treatment planning for patients with peripheral arterial disease and other vascular conditions.
With expertise spanning the brain and body, our specialized clinic provides minimally invasive vascular treatment and a continuum of specialist care under one roof.
If you have been diagnosed with peripheral arterial disease, have a heavily narrowed or calcified artery, have been referred for atherectomy or are seeking a specialist second opinion, our team can help you understand your condition and available treatment options.
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