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Over time, plaque - a fatty substance made up of cholesterol, calcium and other materials - builds up in our arteries. When an artery becomes blocked by plaque, it can cause a heart attack, stroke or painful blockages in the blood vessels of the legs. If plaque is soft enough, a specially trained physician called an interventional cardiologist can insert a thin tube with a tiny balloon at the end into the artery and open the balloon to push aside the plaque and reopen the artery for blood flow. This procedure is called angioplasty. But what if the plaque is too hard for angioplasty? That is where rotablation, or rotational atherectomy, comes in.
As calcium builds up in the artery walls, plaque can become extremely rigid and hard - too hard for an angioplasty balloon to stretch the artery open. To solve this problem, medical researchers designed the rotablator, a small drill with a burr on the end that is coated in diamond dust. You might sometimes hear a rotablator called a “diamond rotor” for this reason. The rotablator drills through the calcified plaque, breaking up the plaque into tiny pieces as it works. These pieces of plaque are small enough to be safely picked up by your bloodstream and eventually your body eliminates them.
When blood vessels are heavily diseased, a cardiologist may turn to rotablation to clear the arteries, says thoracic surgeon Omid Javadi, MD, of Good Samaritan Hospital. In this video he offers the 411 on the process of rotablation.
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