New, Non-Surgical Treatments for Peripheral Artery Disease

Tuesday, February 16, 2010

As seen in the February 2010 Issue of the Ozaukee News Graphic 'Ask the Doc' column.

New, Non-Surgical Treatments for Peripheral Artery Disease
By Andrew Feiring, MD
Today’s new, non-surgical treatments are saving limbs and lives for people with peripheral artery disease or PAD, a buildup of plaque in the peripheral arteries. PAD occurs most commonly in the pelvis, legs, and arteries in the neck. The plaque narrows the inside of the vessels, constricting blood flow.
A buildup of plaque in peripheral vessels is an indication of a buildup in vessels throughout the body. Left untreated, PAD may result in amputation, heart attack, stroke, renal failure, and death.
Symptoms include pain when walking and a foot ulcer or sore that does not heal. Some people may not have significant symptoms. Risk factors for PAD are the same as for heart disease: smoking, diabetes, high blood pressure, high cholesterol level, and family history of vascular disease. The disease affects up to 12 million people in the United States.
The earlier the disease is detected and treated, the better the outcome and the lower the risk for heart attack, stroke, and leg amputation. While PAD can be treated with diet, exercise, and some medications, a procedure to open the blocked arteries is the only way to restore normal blood flow. The good news is that blocked leg arteries often can be opened using newer non-surgical methods.  
New and effective treatments for PAD include:

  • Leg stents—Stents (tiny steel mesh tubes) were first used to prop open blocked heart arteries. The stent is threaded into a blocked artery as part of an angioplasty procedure. Once in the artery, the stent is expanded to increase the diameter of the vessel and improve the blood flow to the heart. Leg stents, inserted into a leg artery through a catheter, are particularly effective for opening blocked vessels below the knee and greatly reduce the need for amputation.  At CSM we are an international leader in treating patient in jeopardy of leg amputation with these specialized stents.
  • Atherectomy Devices—This new device, which actually slices away plaque from within a narrowed artery, consists of a thin, flexible tube with a tiny rotating blade that is inserted into a blood vessel. The blade spins, cutting into the plaque without stretching the vessel. This device appears to do a better job than stents to open arteries in the knee and the lower part of the thigh.  At CSM we have three different plaque removal devices, one that shaves the inside of the artery, a low speed drill and high speed drill.
  • Balloon Angioplasty—In this procedure, a thin flexible tube (catheter) is inserted through an artery and guided to the place where the artery is narrowed. Once the tube reaches the narrowed artery, a small balloon at the end of the tube is inflated. The pressure from the inflated balloon presses the plaque against the wall of the artery to improve blood flow. 

These treatments relieve symptoms, increase independence, and prevent leg amputations and, in conjunction with aggressive risk-factor modification, greatly reduce the risk of serious heart and vascular events. Each is a tool for improving blood flow, and the choice of which one(s) to use varies with each patient.

Dr. Andrew Feiring is the Director of the Cardiac and Catheterization Labs at Columbia St. Mary’s Hospitals on Milwaukee’s east side. 



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