Insertion Of A Stent May Save From Leg Amputation

Insertion Of A Stent May Save From Leg Amputation.
When angioplasty fails, patients with cruel external arterial disease may now have another option. A drug-releasing stent placed in the blocked artery below the knee might re-establish blood flow, renewed investigation shows.

Critical limb ischemia, the most severe form of peripheral arterial disease (PAD), causes more than 100000 part amputations in the United States each year. Now, researchers from Mount Sinai Medical Center in New York City chance insertion of a stent can curb many of these amputations.

In "Traditional balloon angioplasty is plagued by high incidence failure, restenosis (recurrence) and impotence to elevate the patient's symptoms," said lead researcher Dr Robert A Lookstein, colleague director of Mount Sinai's division of interventional radiology. Patients with deprecative limb ischemia have leg pain even when resting and sores that don't heal because of lack of circulation. They are at jeopardize of gangrene and amputation.

But placing a stent in the affected artery during angioplasty greatly improves these problems. The drug-eluting stent keeps the narrowed artery humanitarian and releases a medication for several weeks after implantation, preventing the artery from closing again. "Patients with the least wicked texture of the (severe) disease, those with pain at rest, as well as the patients with minor skin infection of their legs, were able to keep off major amputation".

But some patients with severe disease and those with gangrene still lost a limb who was scheduled to adduce the finding Monday at the Society of Interventional Radiology's annual meeting in Tampa, Fla. For the study, Lookstein's body followed 53 patients with critical limb ischemia who had a all-out of 94 drug-eluting stents implanted to treat leg arteries that would not stay open after angioplasty alone. These are the same stents commonly old to open blocked coronary arteries. The remedying was effective in all the patients, the researchers said.

A year after the procedure, 81,8 percent of the stented arteries were still open, allowing blood to superabundance freely, the researchers found. And, over an norm of 17 months' follow-up, fewer than 10 percent of the patients required a major amputation. "These results show that when angioplasty doesn't work, this is an the best option. Patients should know that if angioplasty fails, there are care options that offer excellent outcomes."

Dr Juan Pablo Zambrano, an aid professor of clinical medicine at the University of Miami Miller School of Medicine, said a downside of stent insertion is the call to take blood-thinning drugs for at least a year after surgery. "The in vogue recommendations for drug-eluting stents require taking antiplatelet drugs for one year". This is commonly a combination of a drug like Plavix and aspirin.

Not taking them greatly increases the chances of clotting in the stent, which can cause a thrombosis (a blood clot), and the strong that a clot will break loose and travel to the spunk or lungs. "If you leave these patients without treatment, you get very early amputations. If you can change the chance of the disease by stenting those vessels and keeping them open for longer, then you are going to have a significant impact".

About 10 million Americans permit from peripheral arterial disease, but only one in four is diagnosed and treated, according to background dope with the study. The condition results from plaque build-up, which hardens in the arteries, blocking and reducing blood course to the legs, arms, brain and other organs. Bypass surgery, the standard healing to open an artery, isn't an option for many patients because of other medical problems.

He said their results show that stent insertion is as remarkable as bypass surgery. The alternative is angioplasty, which involves threading a catheter through the artery and inflating a balloon at the clue of the catheter to open the vessel. But arteries below the knee often concentrated up again after angioplasty m. Those patients would be candidates for a stent in the artery.