Mar 14, 2017
One in every 20 Americans over the age of 50 experiences peripheral artery disease, or clogged arteries, and it’s usually in the legs. That can cause extreme pain and increase the risk for heart attack and stroke.
Now, with a new approach to leg stents, some patients not only walk again, they can even run.
Seventy-three-year-old Ellen Bergami is running competitively again, but a year ago she experienced so much pain in her leg that she was facing amputation.
“I cannot tell you how much pain you are in cause it’s like a tourniquet on your leg shutting down and you’re getting no blood,” Ellen explained.
Ellen was experiencing an acute form of peripheral artery disease that was shutting down the blood flow to her right leg. After a series of failed procedures, she was still in constant pain and addicted to fentanyl.
“I think that she was at a point where she had so much pain in her foot that I think if she wanted, or required an amputation, she would have been relieved,” explains Dr. Mirza Baig, a vascular surgeon at Baylor Scott & White Medical Center – Irving.
Doctors replaced Ellen’s old metal stents with fabric stents. Drug-coated balloons at the ends kept the femoral artery open. These new stents have lasted more than a year and a half, and they changed Ellen’s life.
“I think drug-coated balloons are going to turn out to be a medical breakthrough. I think that the data so far is pretty good,” Baig says.
Recently, Ellen ran a 5k and finished third in her age group.
The drug-coated balloons, approved by the FDA in 2015, are showing good outcomes and reducing the need for repeat procedures.
BACKGROUND: Peripheral artery disease, also known as PAD, is a condition in which arteries are narrowed reducing the blood flow to legs, stomach, arms and head. It is more likely to stop blood flow to the legs, and it is very similar to coronary artery disease. The lack of blood can lead to symptoms like cramping or excruciating pain. PAD can put someone at risk for developing other diseases like coronary heart disease, heart attack, stroke, and transient ischemic attack. One in every 20 Americans suffers from peripheral artery disease.
TREATMENTS: Treatments for PAD do exist. They focus on lowering the level of pain the patient might be going through, as well as stopping the progression of atherosclerosis to reduce the risk of heart attacks and strokes. The easiest treatments involve lifestyle changes like quitting smoking (if the patient does smoke), eating healthy and exercising. When lifestyle changes don’t help, medicine might be prescribed by the doctor in order to prevent blood clots, lower blood pressure and cholesterol, and to control pain and other symptoms. Other forms of treatment may be:
* Bypass surgery
* Thrombolytic therapy
* Supervised exercise programs
DRUG-COATED BALLOON: Drug-coated balloons are a new form of treatment that is being used for PAD. They are new to the U.S. market and FDA- approved. The procedure consists of inserting a small balloon into the blocked artery. Once in place, the balloon is expanded in order return flow. After the first balloon is deflated, a new balloon, coated with anti-proliferative medication, is inserted in to the same artery. The balloon is then inflated. This drug suppresses growth of smooth muscle cells which are responsible for causing restenosis in arteries (re-blockage of arteries), and it has few major complications. The procedure is done under local anesthesia which is less risky than general anesthesia, and patients are able to return to normal activities shortly after the procedure. There’s still a need for more data to be collected, but so far the results are very promising.