This procedure is normally reserved for the treatment of highly calcified areas in the coronary arterial system.
This specialized procedure involves the insertion of a rotating catheter at up to 180,000 rpm. The obstructing fibrous plaque is pulverized into minute micro particles and washed away into the bloodstream.
Typically, after removal of the device, a balloon or stent procedure follows as previously described.
The catheter used in this procedure has a hollow cylinder on the tip with an open window on one side and a balloon on the other.
When the catheter is inserted into the narrowed artery, the balloon is inflated, pushing the window against the fatty matter.
A blade (cutter) within the cylinder rotates and shaves off any fat that protruded into the window. The shavings are caught in a chamber within the catheter and removed.
This process is repeated as needed to allow for better blood flow. Like rotoblation, this procedure is rarely used today.