When the patient has to undergo angioplasty but the atherosclerotic plaque in the coronary vessels is very hard and it is not possible to open the artery with the conventional method, i.e. it is not possible to open it with the angioplasty or other angioplasty has been done in the past, then Rotational Atherectomy (Rotablation) operation is required.

Rotational Atherectomy is performed by the Interventional Cardiologist, when the coronary angiography reveals that there is a severe narrowing or blockage of the coronary vessels due to the calcium salts that have accumulated in the coronary vessel and have formed a hard plaque that cannot be opened with angioplasty.

Atherectomy is performed by catheterization as is angioplasty. The difference is that atherectomy uses a small drill-like device with a rotating "burr" of diamonds. It is inserted into the lumen of the artery and at a speed suitable to shave and pulverize the calcified atheromatous plaque located in the artery wall. Angioplasty and stenting follow, since the vessel is now more accessible after atherectomy.