Which endovascular modality is specifically described as removing plaque via a device within the artery?

• A. Percutaneous transluminal angioplasty (PTA)
• B. Bare-metal or drug-eluting stents
• C. Atherectomy
• D. Thrombectomy

Answer: (C)

Atherectomy is the endovascular method that removes plaque from inside the artery. It uses a catheter-based device that actually debulks or shaves away the atherosclerotic material, sometimes by cutting, grinding, orbital sanding, or laser ablation, with the debris captured by the catheter or managed with protection to prevent downstream embolization. This direct removal distinguishes it from other modalities: balloon angioplasty expands the vessel by compressing plaque against the wall, stents provide a scaffold to keep the artery open after dilation without removing plaque, and thrombectomy targets and removes clots rather than the atherosclerotic plaque itself. Atherectomy is particularly used for heavily calcified or eccentric plaque to facilitate lumen gain and improve subsequent therapy.