DOCTORS AT Parrish Medical Center in Titusville, Florida have a new weapon in their arsenal in the fight against vascular disease.
Blocked arteries in the legs, difficult to clear with previous devices, now can be treated with the Diamondback 360 Orbital Atherectomy System. The technology uses a diamond-coated crown that orbits when guided through an artery, a more effective technique for removing the hard, calcified plaque that tends to gather in the leg.
The instrument is at home in the hospital’s new $10 million cardiovascular studio, in use since August. The 11,000 square-foot expansion to the hospital includes two catheterization suites.
The device is ideally suited to treat patients with peripheral arterial disease (PAD), a condition that often manifests with calf or thigh pain and leg fatigue. Patients might notice a change in color or numbness in their feet. The condition can be confirmed through a simple screening test that checks blood pressure in the ankle.
PAD is not exclusive to the elderly but also can affect young people, especially if they smoke. The condition is characterized by a buildup of plaque on the interior walls of the arteries that causes the arteries to harden and narrow, reducing blood flow to the legs and feet. The condition is complicated by the fact that more than half the blockages in the lower legs contain difficult-to-re move calcium.
“The nemesis of the legs, below the knee especially, is calcium,” said Dr. Ravi Rao, an interventional cardiologist at Parrish. He and Dr. Joseph Flynn, an interventional radiologist at Parrish, were among the first in Central Florida to offer the treatment option. The Diamondback 360 system, by Minneapolis firm Cardiovascular Systems Inc., won FDA approval in late August.
Dr. Rao explains that, “Other devices work well for removing plaque, but are not as effective against hardened calcium deposits and not necessarily well-suited to use in the leg.” Inserting a balloon to make room for a stent, for example, is an effective technique for treating arteries of the heart. “A leg artery, however, would be compressed by muscles when the patient walked, and the stent would collapse,” Dr. Rao points out. Lasers offer less control over speed and direction, and other plaque-gathering devices either are less effective against calcium, pose greater risk of damaging the vessel wall, or don’t create a large enough opening in the artery.
To use the system, the doctor first inserts a wire through the artery, which serves as a guide for the device, and controls the instrument while monitoring a screen showing its progress. The Diamondback 360 moves through the artery, using the principle of centrifugal force to remove plaque layers. As the crown rotates in elliptical fashion at increasing speed, the force presses the diamond-coated surface against the clogged artery walls. The increasing crown orbit creates a larger opening than other techniques, and the gritty surface of the diamond coating pulverizes calcium so that it can be absorbed by the body’s cells and no longer block blood flow.
Before the device, a patient with extensive calcium blockages would be a candidate for surgery. Now, doctors are able to use a much less invasive procedure to improve vascular health and possibly save the patient’s leg. “That’s huge in quality of life,” Rao said.
THE 411 ON PERIPHERAL ARTERIAL DISEASE (PAD)
Sometimes called a heart attack of the leg, PAD is a life-threatening condition in which a fatty material – plaque – builds up on the interior walls of the blood vessels that carry blood from the heart to the legs and arms. Lower extremity PAD can be an early warning sign of vascular disease elsewhere in the body.
- Between 8 million and 12 million Americans have PAD
- One in three diabetics over age 50 is likely to have PAD.
- PAD patients are at six to seven times greater risk of coronary artery disease, heart attack, stroke or transient ischemic attack - also known as a mini stroke.
- For more information on PAD CLICK HERE.