CARDIAC CATH LAB - Mount Sinai Hospital

Prakash Krishnan, MD
Director Endovascular
Intervention, Cath Lab, on
Peripheral Atherectomy
in Treating Peripheral
Artery Disease
Mount Sinai Heart is a
leader in endovascular
interventions for severe
PAD, which can help
eliminate the need for
amputation in many cases.
Peripheral artery disease (PAD) occurs
when plaque builds up in the arteries
that carry blood to the head, organs
and limbs. When plaque builds up
in arteries, the condition is called
atherosclerosis. Over time, plaque can harden and narrow the
arteries. This limits the flow of oxygen-rich blood to your organs
and other parts of the body. PAD usually affects the legs, but also
can affect the arteries that carry blood from the heart to the head,
arms, kidneys and stomach. The symptoms of PAD depend on
which organ or muscle group the affected artery supplies.
Once PAD is diagnosed, there are many modalities of treatment.
These include medications, exercise, angioplasty, stent, bypass
surgery and atherectomy. The remainder of this passage will focus on
a specific type of atherectomy, endovascular peripheral atherectomy.
Atherectomy is a procedure for opening up an artery by removing
the plaque produced by the build-up of cholesterol and other fatty
substances in the inner lining of the artery from atherosclerosis.
Types
Directional - SilverHawk Plaque Excision System The system
consists of a catheter with a mounted blade, a collection reservoir
and a handheld battery-powered drive unit. The device is made
up of a 135-cm shaft with a cutting assembly, which has a cutting
blade at the proximal end of a nosecone designed to collect the
plaque shavings.
Rotational/Aspiration - Jetstream G2 Jetstream G2 is designed
with an expandable cutting tip for use in debulking via rotational
atherectomy. The catheter includes distal ports located at the tip,
26 Mount Sinai Hospital Cardiac Cath Lab