New Laser Technology Opens Blocked Arteries

By Rallie McAllister

March 30, 2007 6 min read

With more than 60,000 miles of blood vessels crisscrossing the human body, it's not surprising that the circulatory system is prone to a few problems.

One of the most serious problems is peripheral artery disease, a condition characterized by the buildup of cholesterol plaques in the arteries. Peripheral artery disease, or PAD, as it's commonly known, can affect any artery outside the heart and brain, but it most frequently affects the arteries of the legs.

With time, the continued accumulation of cholesterol causes the arteries to become progressively narrower, reducing the flow of blood to the legs and feet. In some cases, PAD can ultimately necessitate amputation of the affected limb.

According to the American Heart Association, eight to 12 million American adults currently suffer from PAD. Unfortunately, nearly three-quarters of these individuals aren't even aware they have the condition.

Many remain undiagnosed simply because they don't have any symptoms of the disease, including pain, numbness or tingling in the lower legs and feet, and sores that don't heal properly. Some undiagnosed PAD-sufferers experience a number of these troubling symptoms, but mistakenly attribute them to other causes.

"In the early stages, patients with peripheral artery disease may not feel it at all," explained Craig Walker, M.D., founder and chief medical officer of the Cardiovascular Institute of the South. "But as blood supply is further reduced, they may begin to experience pain in the leg muscles with walking."

As the condition progresses, leg pain often becomes severe, even during periods of rest. Without proper blood flow, the skin, muscles, and other tissues of the lower extremity are starved of oxygen and nutrients.

As a result, the tissues of the legs and feet can begin to die. Tissue death may manifest as a non-healing ulcer that ultimately progresses to gangrene.

"Peripheral artery disease is the leading cause of amputation in the U.S. at this time," said Walker. "It causes a tremendous amount of pain and suffering."

Even under the best circumstances, amputation is a dangerous surgery that carries a high risk of death. In many cases, limb loss can be avoided with the appropriate treatment.

Treatment often involves a procedure called angioplasty, in which a tiny balloon is inserted into the affected artery and inflated at the site of the blockage, reducing the size of the cholesterol plaque. Angioplasty is often followed by the placement of a small metal coil, called a stent, which widens the artery and holds it open.

When balloon angioplasty and stenting aren't the best options, patients may undergo bypass surgery. Using a healthy blood vessel from another part of the patient's body, or one made of a synthetic material, surgeons reroute the flow of blood around the blocked or narrowed artery.

The development of new technology has given surgeons another option for the treatment of PAD. An FDA-approved device, known as the Spectranetics excimer laser, produces pulsed bursts of ultraviolet light energy that vaporizes cholesterol buildup in clogged arteries.

Known as a cool laser, the device doesn't produce the high temperatures commonly associated with other laser treatments. As a result, patients undergoing excimer laser therapy typically do not experience pain.

Successful treatment brings about an immediate improvement in blood flow to the compromised limb. Even better, treatment with the excimer laser may reduce the need for amputation in patients with severe PAD.

"Most patients who need amputations aren't good surgical candidates: They're just too sick to have the surgery," Walker noted. "With this new technique, we can save limbs in 90 percent of these patients for longer than a year."

Although treatment options for peripheral artery disease are improving, prevention is still the best medicine. Two of the most easily modifiable risk factors are cigarette smoking and lack of regular physical activity.

Among people with PAD, smokers tend to develop symptoms about 10 years earlier than nonsmokers. Walking just three times a week, even for short distances, not only slows the progression of PAD; it also helps reduce the likelihood of developing the disease in the first place.

Diabetes, obesity, high blood pressure, and high cholesterol levels are other important risk factors for peripheral artery disease. Fortunately, many of these conditions can be controlled with the appropriate medications and lifestyle changes.

The good news is that when you reduce your risk for peripheral artery disease, you're simultaneously reducing your risk for heart attack and stroke. The steps that you take to save your limbs could end up saving your life.

Rallie McAllister, M.D., M.P.H., is a family physician in Kingsport, Tenn., and author of "Healthy Lunchbox: The Working Mom's Guide to Keeping You and Your Kids Trim." Her Web site is To find out more about Rallie McAllister, M.D., and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at





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