Drug-eluting stents can continue clogged leg arteries open, preventing amputation with the leg, according to a new research presented at the Society of Interventional Radiology’s 38th Annual Scientific Meeting in New Orleans.
“Peripheral arterial disease (or PAD) is becoming increasingly prevalent due to our aging population and the obesity and diabetes epidemics,” said Robert A. Lookstein, M.D., FSIR, lead researcher and chief of interventional radiology at Mount Sinai Medical Center in New York, N.Y. “Many PAD patients are not candidates for surgery and are seeking minimally invasive options. This therapy is an emerging technology that is safe and effective for treating critical limb ischemia. This treatment helps alleviate pain and avoid amputation,” he noted.
About 20 % of North Americans age 65 or older suffer from peripheral arterial disease, said Lookstein. Those that have PAD avoid getting enough the circulation of blood inside narrowed arteries in their legs and also other extremities. Essentially the most severe kind of the sickness is really a condition called critical limb ischemia, when arteries become dangerously narrow or completely obstructed.
Those that have critical limb ischemia can start to feel pain in their legs at rest and develop sores on their own feet minimizing legs that don’t heal. Should the condition goes untreated, amputation in the foot or leg can be necessary. Drug-eluting stents can open those clogged arteries preventing amputation, in accordance with Lookstein. Within the retrospective study, 107 patients with critical limb ischemia had 171 drug-eluting stents put in blocked leg arteries. 6 months after treatment 90 percent in the stents remained opened. Subsequent check-ups at one as well as years showed only a slight decline, with 84 percent and 70 percent, respectively, of treated arteries remaining open.
All patients inside study treated in early stages of critical limb ischemia made it possible to avoid amputation. Non-invasive balloon angioplasty is usually employed in patients that are negative surgical candidates, but long-term success are poor when small arteries are treated, said Lookstein. With balloon angioplasty, interventional radiologists use medical imaging to advance a smallish tube known as a catheter through arteries and to the site from the blockage.
A smaller balloon is expanded, opening up the blocked artery; however, the vessel often becomes reclogged after a while, a procedure called restenosis. To maintain the arteries from reclogging, doctors can deposit a smaller expandable tube (stent) and keep the artery propped open. Therein study, the stents were drug-eluting, meaning they were impregnated with the immunosuppressant drug much like those taken by organ transplant recipients to prevent the rejection of a new organ.The drug-eluting stent is grafted down the wall with the narrowed artery forcing it open. The drug continues to be emitted after some time, preventing the artery from reclogging.
“The study shows that this technology is superior to balloon angioplasty and rivals the results of surgical bypass,” said Lookstein. “It’s safe, it’s durable and the outcomes are spectacular. The vast majority of patients were able to avoid amputation and dramatically improve their quality of life,” he added.
Reference: “Single-center Experience With Drug-eluting Stents in the Treatment of Critical Limb Ischemia: Mid-term Follow-up,” R. Lookstein, T.J. Ward, A.M. Fischman, E. Kim, S.F. Nowakowski, R.S. Patel, S. Ellozy, A. Vouyouka, P. Faries, M. Marin, Mount Sinai Medical Center, New York, N.Y., SIR 38th Annual Scientific Meeting, April 13, 2013.
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