Doctor Develops Tiny ‘Roto-Rooter’ to Clear Fat From Clogged Arteries

A California doctor’s experimental “Roto-Rooter” has successfully cut fatty deposits from patients’ clogged arteries, and authorities say the device is a promising development in fighting the crippling blockages.

The new device, a rotating drill smaller around than a ballpoint pen refill, and the experimental procedure, called atherectomy, were designed by Dr. John Simpson, a cardiologist in Redwood City.

Early tests on 58 patients showed the device and technique effective at removing plaque--fatty deposits that clog arteries and contribute to heart attacks and strokes, authorities said.

Dr. D. E. Johnson, a pathologist working with Simpson, presented a paper describing the device in Chicago at a recent meeting of the United States and Canadian Academy of Pathology.

“It’s sort of like a Roto-Rooter,” said Dr. John Phillips, a medical professor and chief of cardiology at Tulane University Medical School in New Orleans.

“It’s highly experimental,” he added. “It’s got some theoretical advantages over balloon angioplasty.

About 150,000 Americans last year underwent angioplasty, a non-surgical technique in which a balloon-tipped catheter is inserted into blocked heart arteries and inflated to press the plaque against the artery walls and open the blockage.

In atherectomy, a catheter housing the rotating device is slipped into arteries in the arms, legs or heart. Inside the blocked artery, the device whirls at 2,000 r.p.m., scooping up and removing the plaque, said Roxane Baxter, associate product manager for Devices For Vascular Intervention Inc., the Redwood City company founded by Simpson to manufacture the tool.

“Dr. Simpson was looking for a different way to treat heart disease and vascular disease,” Baxter said in a telephone interview. “He came up with the idea of actually removing plaque from the arteries instead of just pushing it against the walls, as is the case with balloon angioplasty.”

The “Roto-Rooter” device allows removal of the source of the disease, Phillips said. “Theoretically, it should be an advantage. But we don’t know anything about complication rates or reoccurrence rates,” he added.

Simpson has designed two types of atherectomy catheters, Baxter said. One is for removing plaque from arteries in the arms, legs and abdomen, and the second--a smaller device--is designed to remove fatty deposits from the slimmer cardiac arteries.

Since August, 1985, she said, 58 patients at Sequoia Hospital in Redwood City have been treated with the device for plaque buildups in peripheral arteries. The first patient was treated with the coronary artery device Feb. 24.

“They’re all doing fine and we’re in the process of getting as much follow-up data on these patients as we can,” Baxter said.

Preliminary follow-up tests showed that 39 patients treated for peripheral vascular disease had no sign that the fatty deposits were returning when they were examined at intervals ranging from one to 13 months, according to the paper presented in Chicago.

Baxter said more extensive clinical trials began recently at four other hospitals: St. Vincent Hospital in Indianapolis; Alexandria Hospital in Alexandria, Va.; Boston University Hospital in Boston, and Duke University Medical Center in Durham, N.C.