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New technique offers safer option for treating coronary arteries, Polish cardiologist says

02.07.2025 14:30
A medical technique known as orbital atherectomy can be used to modify hardened atherosclerotic plaque inside coronary arteries, making it easier to restore blood flow in advanced coronary artery disease, according to cardiologist Tomasz Roleder of the Wrocław University of Science and Technology in southwestern Poland.
Photo:
Photo:PAP/Darek Delmanowicz

Coronary artery disease occurs when fatty deposits called atherosclerotic plaques build up in the arteries supplying blood to the heart. Over time, these plaques harden due to calcium deposits, narrowing the artery and restricting blood flow.

One common treatment is angioplasty, a minimally invasive procedure that opens blocked arteries to improve circulation.

Orbital atherectomy offers a new way to prepare hardened arteries for this procedure, Roleder said.

Unlike traditional methods such as rotational atherectomy, which drills through the plaque, orbital atherectomy gently sands it down using a crown-shaped tip that rotates at up to 120,000 revolutions per minute.

"This approach is particularly useful when dealing with calcified nodules that jut into the artery," said Roleder in comments shared with the Poland's PAP news agency.

In such cases, the technique can be safer and more precise than alternatives, he added.

Rotational atherectomy may be ineffective or riskier in these scenarios, as it often requires larger burrs, increasing the chance of complications such as vessel perforation.

"Orbital atherectomy helps minimise that risk," Roleder said.

Other common approaches for treating calcified plaques include using small burrs in rotational atherectomy or applying a method called intravascular lithotripsy. The latter involves a catheter that emits sound waves to break apart the calcium, similar to how kidney stones are treated.

Current guidelines from the European Society of Cardiology recommend plaque modification before placing a stent – a wire mesh tube - in severely calcified arteries, but do not specify which method to use.

"Each technique has a different mechanism and advantages," Roleder said. "The choice often depends on availability, cost, and the specific clinical situation."

He explained that orbital atherectomy is especially useful when other methods, such as cutting balloons or lithotripsy, are likely to be ineffective, particularly in the presence of dense, nodular calcium.

Roleder also pointed to the growing importance of imaging in planning and guiding these procedures.

Cardiologists now use coronary CT scans and intravascular imaging technologies, such as ultrasound and optical coherence tomography, to assess the plaque's structure and evaluate treatment outcomes.

"With modern imaging, we can determine whether we’re dealing with massive calcification or specific types of calcified nodules," he said. "These insights help us select the best technique for each patient and reduce the risks involved – risks that, in the case of orbital atherectomy, are significantly lower than with traditional drilling methods."

(rt/gs)

Source: naukawpolsce.pl