Vascular Medicine Conference-CVC 2026

Atherectomy operates more like an arterial cleanup rather than the typical plaque-flattening approach of balloon angioplasty. Rather than compressing plaque against the artery wall, atherectomy devices physically excise or remove the obstructive material, making this technique particularly valuable for patients with peripheral artery disease (PAD) who present with heavily calcified or resistant lesions. These are the cases where standard balloon angioplasty often proves insufficient.

The procedure is generally performed under local anesthesia, with imaging guidance to precisely target the affected arterial segments. Interventionalists may employ catheter-based tools—sometimes outfitted with rotating blades or lasers—to directly clear the blockage. In certain scenarios, atherectomy is followed by adjunctive balloon angioplasty or the placement of a stent to ensure sustained vessel patency.

Long-term outcomes, though, hinge greatly on the management of modifiable risk factors, such as glycemic control, lipid regulation, hypertension, and cessation of tobacco use. With diligent follow-up and risk factor modification, atherectomy can significantly enhance peripheral circulation, reduce symptoms like claudication, and lower the risk of severe complications, including critical limb ischemia and potential amputation.