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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/09/13 05:52:54」(JST)

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Atherectomy is a minimally invasive endovascular surgery technique for removing atherosclerosis from blood vessels within the body. It is an alternative to angioplasty for the treatment of peripheral artery disease, with no evidence of superiority to angioplasty.^[1] It has also been used to treat coronary artery disease, albeit ineffectively.^[2]

Uses

Atherectomy is used to treat narrowing in arteries caused by peripheral artery disease.

Technique

Unlike angioplasty and stents, which push plaque into the vessel wall, atherectomy cuts plaque from the wall of the artery. While atherectomy is usually employed to treat arteries it can be used in veins and vascular bypass grafts as well.

Atherectomy falls under the general category of percutaneous revascularization, which implies re-canalizing blocked vasculature via a needle puncture in the skin. The most common access point is near the groin through the common femoral artery (CFA). Other common places are the brachial artery, radial artery, popliteal artery, dorsalis pedis, and others.

There are four types of atherectomy devices: orbital, rotational, laser, and directional.

The decision to use which type of device is made by the interventionist, based on a number of factors. They include the type of lesion being treated, the physician's experience with each device, and interpretation of the devices' risks and effectiveness, based on a review of the medical literature.

References

^ Ambler, GK; Radwan, R; Hayes, PD; Twine, CP (17 March 2014). "Atherectomy for peripheral arterial disease.". The Cochrane database of systematic reviews 3: CD006680. PMID 24638972.
^ Wasiak J, Law J, Watson P, Spinks A (December 2012). "Percutaneous transluminal rotational atherectomy for coronary artery disease". Cochrane Summaries.

UpToDate Contents

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1. 下肢跛行患者における経皮的インターベンション percutaneous interventional procedures in the patient with lower extremity claudication
2. 冠動脈疾患のマネージメントにおける血行再建術専用デバイス specialized revascularization devices in the management of coronary heart disease
3. 大伏在静脈グラフトの狭窄の予防、症状、およびマネージメント prevention presentation and management of saphenous vein graft stenosis
4. アテローム切除デバイスの冠動脈合併症 coronary complications of atheroablative devices
5. 冠動脈ステント血栓症：発症率および危険因子 coronary artery stent thrombosis incidence and risk factors

English Journal

Neointimal Hyperplasia after Silverhawk Atherectomy versus Percutaneous Transluminal Angioplasty (PTA) in Femoropopliteal Stent Reobstructions: A Controlled, Randomized Pilot Trial.

Brodmann M, Rief P, Froehlich H, Dorr A, Gary T, Eller P, Hafner F, Deutschmann H, Seinost G, Pilger E.SourceDivision of Angiology, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria, marianne.brodmann@medunigraz.at.
Cardiovascular and interventional radiology.Cardiovasc Intervent Radiol.2013 Feb;36(1):69-74. doi: 10.1007/s00270-012-0479-9. Epub 2012 Sep 25.
BACKGROUND: Due to intimal hyperplasia instent reobstruction in the femoropopliteal arterial segment is still an unsolved problem. Different techniques have been discussed in case of reintervention to guarantee longlasting patency rate.METHODS: We conducted a randomized, controlled, pilot trial comp
PMID 23007223

The state of the excimer laser for coronary intervention in the drug-eluting stent era.

Badr S, Ben-Dor I, Dvir D, Barbash IM, Kitabata H, Minha S, Pendyala LK, Loh JP, Torguson R, Pichard AD, Waksman R.SourceInterventional Cardiology, MedStar Washington Hospital Center, Washington, DC 20010, USA.
Cardiovascular revascularization medicine : including molecular interventions.Cardiovasc Revasc Med.2013 Jan 16. pii: S1553-8389(12)00294-1. doi: 10.1016/j.carrev.2012.12.008. [Epub ahead of print]
OBJECTIVES: This study aims to determine how excimer laser coronary atherectomy (ELCA) performs in the drug-eluting stent (DES) era.BACKGROUND: For more than 20years, ELCA has been used for coronary intervention. With developments in the coronary intervention field, the role of ELCA is in question.M
PMID 23332778

Prescribing patterns of antiplatelet agents are highly variable after lower extremity endovascular procedures.

Allemang MT, Rajani RR, Nelson PR, Hingorani A, Kashyap VS.SourceDivision of Vascular & Endovascular Therapy, University Hospitals Case Medical Center, Cleveland, OH.
Annals of vascular surgery.Ann Vasc Surg.2013 Jan;27(1):62-7. doi: 10.1016/j.avsg.2012.05.001. Epub 2012 Sep 12.
BACKGROUND: The use of antiplatelet and antithrombotic agents after peripheral vascular interventions is a common clinical practice despite a lack of clear convincing evidence or accepted practice guidelines. The goal of this study was to assess surgeons' prescribing practices after endovascular pro
PMID 22981017

Japanese Journal

Influence of additional ballooning with a dual wire balloon after a rotational atherectomy to expand drug-eluting stent for calcified lesions

Kato Ryuichi,Ashikaga Takashi,Sakurai Kaoru [他]
Cardiovascular intervention and therapeutics 27(3), 155-160, 2012-09-00
NAID 40019426560

Surgical Treatment for Ellis Type 3 Coronary Perforation During Percutaneous Catheter Intervention

TOTSUGAWA Toshinori,KUINOSE Masahiko,YOSHITAKA Hidenori,KATAYAMA Keijiro,TSUSHIMA Yoshimasa,ISHIDA Atsuhisa,CHIKAZAWA Genta,HIRAOKA Arudo
Circulation journal : official journal of the Japanese Circulation Society 76(2), 377-381, 2012-01-25
… The causes of perforation were balloon inflation in 4 patients and rotational atherectomy in 1 patient. …
NAID 10030035669

Increased Expression of Oxidative Stress in Proliferated Vascular Smooth Muscle Cells in Early Stage of Human Restenosis After Coronary Angioplasty

OIGAWA TETSUYA,SUZUKI HIROMASA,SUNAYAMA SATOSHI [他]
順天堂医学 58(1), 35-43, 2012-00-00
NAID 40019227140

Related Pictures

★リンクテーブル★

リンク元	「粥腫切除」「粥腫切除術」「アテレクトミー」
拡張検索	「coronary atherectomy」「directional coronary atherectomy」

「粥腫切除」

Atherectomy
	Intervention
	Illustration of three types of atherectomy devices being used to remove plaque in a blood vessel
ICD-9-CM	39.50, 00.61 -00.62
MeSH	D017073