SEATTLE, March 5 (UPI) -- A new generation of thinner catheters and small, more flexible stents -- tiny stainless-steel mesh coils that prop open endangered blood vessels -- appear able to save the legs of patients with painful, gangrenous peripheral artery disease.
"These are patients who are out of options and they face amputation of their lower legs," said Neal Saad, resident in imaging sciences at the University of Rochester Medical Center in New York.
PAD affects 12 percent to 20 percent of people in their 50s and 50 percent to 60 percent of people 70 to 85 years of age, Saad said Monday at the 32nd annual meeting of the Society of Interventional Radiology in Seattle.
"The first symptoms of peripheral artery disease are pain and cramping in the legs, leading to worsening symptoms that eventually may include ulcers and gangrene," he said. The condition is caused by blockages in leg arteries.
Historically, attempts to open these clogged leg arteries with angioplasty techniques and stenting has not met with much long-term success, but in Saad's study, 85 percent of the leg arteries were open after one year; 77 percent of the blockages remained open two years after the procedure. Retreating the legs that re-clogged resulted in 92 percent of the leg arteries being open after two years.
Saad treated 59 limbs in 57 patients. There were a total of 96 blockages that were treated in the patients' legs. The procedure was successful in opening 97 percent of the blockages, Saad told United Press International.
Treatment of the larger blood vessel above the knee has been accomplished for several years, but the smaller blood vessels are more difficult to treat and more difficult to maintain patency, said Brian Stainken, chief of interventional radiology at Roger Williams Medical Center in Providence, R.I.
"We now have very small stents and more flexible catheters that can open up these smaller blood vessels," he told UPI. Stainken moderated a news briefing at which new developments in these devices were discussed.
"This study shows that, with angioplasty and stenting, we can restore blood flow through the smallest vessels in the legs and keep them open long-term, saving these patients from life-altering amputation," Saad said. "Aggressive interventional therapy should be considered in all patients as a first option. In general, the long-term clinical results are comparable to by-pass surgery in the leg using a longer, more complex graft, but with a much lower risk of morbidity and mortality."
In his study of patients whose next option was amputation, Saad said that treatment with the catheters eventually saved 43 of the 57 legs at risk. Of the patients in the study -- all of whom have extensive cardiovascular disease -- 14 of the 18 patients who died did not have an amputation.
Overall, after two years 29 patients were alive with intact limbs; 10 other patients were alive but needed an amputation.
