Why can’t we just bore/remove the clogging material in arteries than just putting in a stent in Angioplasty?
In: Biology
1. The plaques are pretty tightly bound to the walls of the arteries. Think plaque on your teeth.
2. If a piece of even moderate size breaks free, it could cause a stroke in a few seconds.
So, stents are the invasive option that gives the most benefit for the lowest risk. Although for most patients, the long-term outcome of a stent is not statistically better than using medication instead.
How can you reach the clogging material other than putting a stent without damaging the artery
We do. There’s a surgery called [endarterectomy](https://en.wikipedia.org/wiki/Endarterectomy) where you open an artery and remove the plaques. You must also remove the entire adjacent endothelium. It’s usually performed on the carotid artery. It may or may not lead to more complications than stenting. From Wikipedia:
>One trial found that stents and endarterectomy were comparable while another found that stents had almost double the rate of complications.
https://en.wikipedia.org/wiki/Carotid_endarterectomy
In certain situations, they do use devices to bore through bore through plaques. But this works only in vessels that are big enough for the device and where there is lower risk of just boring through the side of the vessel. The big concern, though is what happens when you put a whole in the plaque. Just like when you skin is injured, when a vessel is injured, your body reacts by making a clot. This could be a very bad thing if the clot blocks the entire vessel.
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