March 1, 2004
HOUSTON, TX - The Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC) is among the first hospitals in the country to use cryoplasty to open clogged leg arteries and improve blood flow to the lower extremities. This is good news for veterans who suffer from peripheral arterial disease (PAD) of the lower extremity.
According to the American Heart Association, about 12 million Americans have some degree of PAD. It is more common with increasing age, affecting about five percent of people over 50 and 20 percent of those 70 and older. Besides age, other risk factors include smoking, diabetes, high blood pressure, and family or personal history of heart disease.
PAD is a narrowing of the arteries in the extremities, most commonly involving the blood vessels in the legs. The condition is usually caused by atherosclerosis or a build-up of fatty blockage in a blood vessel. This can prevent adequate blood flow to the legs and feet.
In the early stages, PAD can lead to cramping pain in the leg or hip, usually when the patient is walking or otherwise active. As the condition progresses and the blood vessel becomes more narrow, the pain occurs more frequently and eventually even when the patient is simply sitting or lying down. In extreme cases, skin ulcerations can develop, leading to gangrene and frequently, amputation.
Traditional treatments to open partially blocked vessels have included balloon angioplasty. Similar to angioplasty for the heart, a balloon-tipped catheter is placed inside the blood vessel to relieve the blockage. While these procedures are less invasive than a bypass operation and work well initially, reclogging of the blood vessel can occur and the patient will need another balloon angioplasty or a bypass operation.
Vascular surgeons at the MEDVAMC are now using a revolutionary medical device called the PolarCath System to improve the lower leg arterial blood flow. This new technique, also known as cryoplasty, is designed to reduce the number of patients who have to be re-treated for this painful circulation problem.
The PolarCath system, which was recently approved by the FDA for use in the lower leg blood vessel, differs from conventional balloon angioplasty because it inflates the balloon with pressurized nitrous oxide gas instead of the conventional saline or contrast solution. In this cryoplasty procedure, liquid nitrous oxide gas is used to inflate the balloon while also cooling the balloon's temperature down to -10ºC (14º F). Physicians believe this tends to cause less damage to the blood vessel while the balloon is opened in the artery.
"The cryoplasty procedure is extremely promising because it provides another option to treat patients with even the most challenging clinical cases," said Peter Lin, M.D., chief of Vascular Surgery at the MEDVAMC. Lin along with two other MEDVAMC physicians, Alan Lumsden, M.D. and Ruth Bush, M.D. have been treating veterans with PAD for many years. They are nationally know for their expertise in the management of PAD.
"For patients with PAD, the benefit of the cryoplasty procedure is even more exciting, which includes the elimination of pain and potentially fewer visits to the hospital to treat recurrent disease of the vessel," said Bush.
In clinical trials conducted to evaluate the outcome of the cryoplasty procedure, 85 percent of treated leg arteries remained open at nine months. In addition, the number of patients requiring repeat treatment after the cryoplasty procedure was substantially less when compared to those treated with the conventional balloon angioplasty procedure.
"About 40 percent of patients treated with the conventional angioplasty technique need to be treated again within a year. With the cryoplasty procedure, the incidence of repeat treatment is only 15 percent, a significant improvement," said Lumsden.
If you are a veteran and are interested in learning more about this new treatment of the lower leg artery blockage and PAD, please contact the MEDVAMC Vascular Surgery Clinic for more information (713) 794-7895.
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Point of Contact: VHAHOU Public Affairs03/02/04 06:48