After performing his 100th atherectomy at VCU Health, Dr. Lorenzo Azzalini discusses this valuable cardiovascular procedure — a surgery many heart centers don’t offer.

Normally performed during other coronary blockage interventions, atherectomy is a procedure which breaks up calcified plaque in the artery. This, in turn, improves blood flow and reduces chest pain.

“While a normal coronary intervention takes 30-45 minutes, those with atherectomy usually take 1-1.5 hours,” Dr. Lorenzo Azzalini stated, explaining that the extra time needed is due in part to its complexity. “We use atherectomy as a first-line strategy, though, which cuts procedural time considerably and is associated with less complications.”

Less than 2% of coronary blockage interventions are performed with atherectomy, according to data from the National Cardiovascular Data Registry. Due to an increased perception of risk, a third of hospitals around the country do not offer atherectomy as a treatment option.

Some health care providers think of atherectomy as having a higher risk of complications, although data indicates the number of problems during the procedure is rather low. “All of these complications, together, account for about five percent of cases,” said Dr. Azzalini.

Patients undergoing atherectomy are usually discharged the day after the procedure. This extra time allows their cardiology team to monitor possible complications.

While many providers prefer to treat coronary artery blockage with medicinal and other conventional procedures, Dr. Azzalini and his team at VCU Health are excited to offer atherectomy as part of primary intervention in coronary artery blockage.

Learn more about atherectomy and coronary artery treatments.