Stenting Procedure Prevents Leg Amputations

Friday, May 26, 2006

Procedure Saving Limbs and Lives for Patients That “No One Else Would Touch”

Milwaukee, Wis., June 1, 2005 — People with severe peripheral vascular disease (PVD) in their legs have a greatly reduced chance of needing an amputation with an innovative stenting procedure performed at Columbia St. Mary’s.

Vascular interventional cardiologist Andrew Feiring, MD, based at Columbia St. Mary’s Columbia Campus, has the most extensive limb salvation experience in Wisconsin. As Director of the Cardiac and Catheterization Lab at Columbia St. Mary’s Columbia Campus, Dr. Feiring leads one of only 10–15 limb stenting programs in the country.

PVD is a serious circulation disorder that affects blood vessels away from the heart, such as those in the arms and legs. PVD is an indication of systemic atherosclerosis (hardening of the arteries). Left untreated, it can lead to heart attack and stroke. Risk factors are the same as those for coronary artery disease: diabetes, high blood pressure, high cholesterol, family history of vascular disease, and smoking.

A foot ulcer or sore that does not heal is a strong indication of advanced PVD. When blood flow to the legs is reduced by cholesterol plaque, foot ulcers can develop. About 25 to 30 percent of people with foot ulcers are at risk for amputation within one year. The death rate also is high; within one year, 20 to 25 percent of people with foot ulcers will die, and 60 percent of people will die within three years. Leg pain when walking is another symptom of PVD.

In the past, surgery for people with severe PVD below the knee, many of whom are elderly, resulted in a 5 to 10 percent chance of mortality one month after surgery. The only other option was to live with the pain and take medication, or have the blocked leg(s) amputated and lose independence—or wait to die of the condition.

In recent years, Dr. Feiring has pioneered the use of stents below the knee, similar to the stenting procedure used to open blocked heart arteries. A stent—a tiny steel mesh tube—provides a non-surgical way to open blocked arteries. The stent is threaded into a blocked artery as part of an angioplasty procedure, and is expanded to increase the diameter of the vessel and improve the flow of blood.

To date, Dr. Feiring has performed 150 stenting procedures in patients that “no one else would touch” (other health care providers would not treat the patients due to their age and/or severity of disease). The outcomes have been excellent. Among the people who have undergone a stenting procedure at Columbia St. Mary’s, only 13 percent have died within three years (compared with 60 percent within three years for people who don’t have the procedure), and fewer than 5 percent of patients required an amputation.

Healing of foot ulcers can be a long and difficult process. The Wound Healing Center at Columbia St. Mary’s also plays an important role in caring for patients with foot ulcers by treating their slow-to-heal ulcer wounds.

Data on Dr. Feiring’s limb-stenting procedures were published in the December 21 issue of the Journal of the American College of Cardiology.

About Columbia St. Mary’s
Columbia St. Mary's is comprised of four hospitals: Columbia St. Mary's Hospital Milwaukee, Columbia St. Mary's Columbia Campus, Columbia St. Mary's Hospital Ozaukee, and Sacred Heart Rehabilitation Institute, as well as 28 primary care clinics, the Columbia College of Nursing, a partnership with the Orthopaedic Hospital of Wisconsin, the new River Woods Outpatient Center in Glendale, and new Urgent Care Center in downtown Milwaukee. The system serves individuals and families in Milwaukee, Ozaukee, and Washington counties, with more than 158 years of service. In 2006, Columbia St. Mary’s was named a Solucient Top 100 Hospital. Columbia St. Mary's and its sponsor organizations, Ascension Health and Columbia Health System, share a mission to make a positive difference in the health status and lives of individuals in the community with a special concern for those who are vulnerable.  


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