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StatPearls, LLC

  • Angioplasty, Balloon
  • Atherectomy, Coronary
  • Coronary Artery Disease
  • Plaque, Atherosclerotic
  • Stents

Rotational Atherectomy

Coronary stenoses with circumferential or significant vessel calcification are rigid and frequently not dilatable with use of conventional balloon angioplasty. Often stent dilation and maximal vessel wall apposition are compromised in extensively calcified coronary lesions, stents deployed in heavily calcified vessels without atherectomy tend to thrombose, restenosis, and could cause stent fracture. Significant calcification remains a major limitation of balloon angioplasty as well as successful stent delivery to severely affected vessels. In cases with heavily calcified lesions, high-pressure, non-compliant balloon inflations may still fail to dilate adequately and prepare a heavily calcified vessel for stent delivery. This activity reviews the indications, contraindications, and complications of rotational atherectomy and highlights the role of the interprofessional team in the management of patients with CAD. Atherectomy refers to the removal of the obstructing material, and in our case this is calcium. By removing significant calcification or modifying the calcified atherosclerotic plaque vessel wall compliance in calcified or fibrotic lesions is increased, and the lumen diameter gained from using this device will be much improved as compared to the use of simple balloon angioplasty. Rotational atherectomy is one of several ways to perform atherectomy in a coronary vessel. It is the most commonly used atherectomy device and removes atheromatous plaque by differential cutting, that is removing the inelastic calcified plaque with microscopic (20 to 50 micrometers) diamond chips embedded on the surface of a rapidly rotating (150,000 to 200,000 rpm) olive-shaped burr. Such abrasion generates 2 to 5-micrometer microparticles that propagate through the coronary microcirculation and are removed by the reticuloendothelial system. The burr travels over a specialized 0.009-inch guidewire and is available in diameters ranging from 1.25 to 2.50 mm. In the setting of severe…

Credit & MOC Details

Credit information is provided by the course provider. We recommend confirming credit eligibility with the provider or your licensing board before starting the activity.

Credit types

AAPA Category 1 Credit™Up to 1.5 creditsAMA PRA Category 1 Credit™Up to 1.5 creditsNursingUp to 1.5 creditsPharmacyUp to 1.5 credits

MOC types

ABS — Accredited CMEUp to 1.5 pointsABPATH — Lifelong LearningUp to 1.5 pointsABA — Lifelong LearningUp to 1.5 pointsABTS — Accredited CMEUp to 1.5 pointsABIM — Medical KnowledgeUp to 1.5 pointsABS — Self-AssessmentUp to 1.5 pointsABP — Lifelong Learning and Self-AssessmentUp to 1.5 pointsABTS — Self-AssessmentUp to 1.5 points

FDA REMS

No

Qualifies for MIPS

No

Target Specialties

Cross-Specialty

Relevant across 8 specialties.

Pricing

Fee varies

This provider typically $49–98

See fees on statpearls.com

Listed by the provider

  • Article / monograph / reference
  • Credit · Up to 1.5 credits
  • MOC · Up to 1.5 points
  • Fee varies · this provider typically $49–98
  • Released
    Sep 1, 2026
  • Last day to claim credit
    Sep 1, 2029 3 years left

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