A rotablator, which was
first introduced in 1993, is a miniature drill
capped with an abrasive, diamond-studded burr. The
rotablator is used in a type of catheter-based procedure
called rotational atherectomy.
is a minimally invasive treatment that is sometimes used
to pulverize hardened plaque within a coronary
artery. During rotational atherectomy, the rotablator is
guided to the blockage via a catheter – a thin,
flexible, hollow plastic tube small enough to be
threaded through a blood vessel.
Your doctor may
feel the particular plaque formation closing off one of
your arteries can be managed better using a
rotablator procedure (RP). This procedure is used
- The plaque is felt to be too
difficult to flatten against the artery wall with just
- The plaque appears to have a
large amount of calcium present in it and won’t move
- The plaque is too long or
starts where the artery begins.
- The artery has too much
plaque, which needs to be removed before doing another
- The artery is felt to be too
small for other procedures.
- A PCTA and/or stent has been done before and the
lesion has reclosed.
During this procedure a very small device called a
rotablator is used. It is the shape of a tiny football
and comes in many sizes to suit various arteries. It is
threaded over a guidewire through the catheter that is
used to inject dye at the blockage site.
The tip of the rotablator is coated with very tiny
pieces of diamond crystals. Air pressure (turbine) is
used to power and rotate the tip at very high speeds
against the plaque. When the tip is rotated, it sounds
much like the tools a dentist might use. Short bursts of
power will be used to rotate the tip up to 190,000 rpm.
This will grind or break the plaque down into very small
particles. These particles are the size of sand dust
which are smaller than a red blood cell. The dust is
flushed downstream in the blood with IV fluids to be
cleaned up and removed by the body’s natural defenses.
The diamond cystal tip will only grind the plaque
because it is firmer and more rigid than the soft
flexible tissue of the artery itself. This is much like
shaving brittle hair off of soft skin.
You may experience some angina during the procedure
because the artery is blocked. Be sure to let your
doctor know if this occurs. It is common to feel a
little sore or bruised inside your chest after an RP.
This will go away in a day or two.
The rest of your hospital stay after an RP is usually
one night and is much like recovering from a regular
When you are discharged, follow the general PTCA
guidelines for going home in the previous pages of this
section of the book. Your doctor, nurse or cardiac
educator will review with you any special activity
guidelines you may have, and your medications. All your
cardiac drugs are covered in detail in the medication
section of this book. It is important that you take
these drugs as directed, and keep your doctor’s