Peripheral Artery Stenting Saves Limbs

New research shows angioplasty and stenting can prevent amputation and restore blood flow in the lower extremities of patients with severe critical limb ischemia and gangrene.

Researchers from the University of Rochester Medical Center (NY, USA) conducted a study on 47 patients (66% men, mean age 73) with peripheral arterial disease (PAD), who had 81 blockages below the knee that were treated by stenting and angioplasty. The patients had the following risk factors that are also indicative of PAD: 85% had a smoking history, 62% a cardiac history, 91% were hypertensive, 55% diabetic, 53% had kidney disease, 53% were obese, and 60% had hyperlipidemia.

The results showed that primary patency using angioplasty and/or stenting was 75% at three months and 55% at 18 months. By re-treating the artery that became re-clogged, the artery remained open, saving the limb in 91% at 18 months follow-up. This success rate was consistent in all patients who were consecutively enrolled over a six-year period. The study was presented at the Society of Interventional Radiology's 32nd annual scientific meeting, held during March 2007 in Seattle (WA, USA).

"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,” said lead author Nael Saad, M.D., an interventional radiologist. "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.”

Peripheral arterial disease (PAD), also known as peripheral vascular disease (PVD), is a systemic disease affecting 12-20% of North Americans age 65 and older. PAD develops most commonly because of atherosclerosis, which narrows and clogs the arteries. Although PAD in general is treated non-surgically via stenting and angioplasty, in many cases the superficial femoral artery is still being treated surgically.


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