What is a rotablation?

Cardiac catheter laboratory

I recently had an angiogram and was told that I need a rotablation. Please can you explain what this is?

Professor Peter Weissberg says:

An angioplasty procedure is used to help relieve symptoms of angina. This is where a guide wire is passed into an artery in your heart that has become narrowed by a build- up of plaque.

A tiny balloon is inserted along the wire and then inflated to squash the plaque to the sides and improve the flow of blood through this section of the narrowed artery. This is often followed by the insertion of a metal mesh, called a stent, which holds the artery open after the balloon is withdrawn.

Sometimes, when the plaque is particularly hard, or is so narrow that the balloon can’t pass through it, rotablation may be used. Again, a very fine wire is guided through the narrowing.

After this, a special catheter (a thin tube) is inserted along the wire with a tiny drill at its tip, powered by compressed air. This drill is used to chip away at the plaque to gradually widen the narrowing. Once this has been done, a balloon can be inserted and the angioplasty can proceed as normal.

You’ll be awake for the procedure. Although the drill can be surprisingly noisy, it’s not painful, but as with an angioplasty, you may feel some minor chest discomfort. A local anaesthetic is used at the site in your groin or wrist where the catheter is inserted.

Professor Peter WeissbergMeet the experts

Professor Peter Weissberg is the former Medical Director of the BHF and Honorary Consultant Cardiologist to Addenbrooke’s Hospital. He has a special interest in atherosclerosis.

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