Peripheral Artery Disease Treatment Improved

A new approach to clearing plaque from arteries is helping doctors treat patients who require a procedure called balloon angioplasty.

Balloon angioplasty is among the standard treatments for peripheral artery disease (PAD). In the U.S., about 8 million people have peripheral artery disease, and about half have no symptoms.

PAD is frequently found in people with coronary artery disease because atherosclerosis, which causes coronary artery disease, is a widespread disease of the arteries.

Disease requires careful management

In PAD, plaque reduces the amount of blood flow to the limbs and decreases the oxygen and nutrients available to the tissue.

Symptoms include painful cramping in the hips, thighs, or calves when walking, climbing stairs, or exercising.

To correct this problem, a doctor inserts a catheter into an artery and guides it to the blockage, then opens the artery by inflating a balloon at the tip of the catheter.

The doctor typically uses a stent to keep the artery open. A stent is a tiny metal “scaffold” that is left open inside the artery to it from reclosing.

Inflating the balloon can knock loose particles of plaque, which travel down the leg. A large particle can block blood flow, a condition called distal embolization. In the most severe cases, distal embolizations can require leg amputation or even be fatal.

Some doctors have used a filter device to prevent debris from escaping, but using this filter isn’t yet approved by the FDA.

New device increases safety for patient

The new report shows that the device that was studied opens the artery just like a standard angioplasty balloon.

After the artery is opened, the doctor deflates the balloon. The negative pressure sucks up the debris, which is trapped inside as the balloon retracts.

Researchers report their findings in the medical journal Endovascular Today.

In two clinical trials totaling 123 patients, the device had a success rate of 97 to 99 percent and consistently outperformed filter devices typically used to capture debris particles, report the study authors.

Robert Dieter, M.D., of the Loyola University Health System, and Dr. Aravinda Nanjundappa, M.D., of West Virginia University, say they expect to see a shift by doctors to using this new method now that it has been approved by the FDA.

Always talk with your doctor to find out more information.

More about PAD

When PAD symptoms occur, the most common is a painful calf cramping called intermittent claudication. It happens with exercise and eases with rest.

The cramping may occur in one or both legs, depending on the location of the clogged or narrowed artery. The pain disappears when you rest because the muscles need less blood at rest.

Other symptoms of PAD may include:

• Changes in the skin, including decreased skin temperature, or thin, brittle, shiny skin on the legs and feet
• Diminished pulses in the legs and the feet
• Gangrene (dead tissue due to lack of blood flow)
• Hair loss on the legs
• Impotence
• Wounds over pressure points like heels or ankles that don’t heal
• Numbness, weakness, or heaviness in muscles
• Burning or aching pain at rest, commonly in the toes and at night while lying flat
• Paleness of the skin when the legs are elevated
• Reddish-blue discoloration of the extremities
• Restricted mobility
• Severe pain
• Thickened, opaque toenails

Steps to prevent PAD are primarily aimed at managing risk factors:

• Smoking cessation, including avoiding secondhand smoke and all tobacco products
• Dietary changes, including reducing fat, cholesterol, and sugar, and increasing amounts of fruits and vegetables
• Treatment of dyslipidemia (high blood cholesterol levels) with medications as determined by your doctor
• Weight loss
• Moderation in alcohol consumption
• Medications as determined by your doctor to reduce your risk for blood clot formation
• Exercising a minimum of 30 minutes daily
• Control of type 2 diabetes
• Control of high blood pressure

A prevention plan may also be used to prevent or lessen the progress of PAD once it has been diagnosed.

Always talk with your doctor to find out more information.