Fellow, Complex Coronary Angioplasty, Japan
Fellow, Interventional Cardiology, Taiwan
Guest Professor of Cardiology, Tiantan Hospital, Beijing
Guest Professor Tan Tao Medical School, Vietnam
Vice Chairperson Coronary Intervention , Asia Pacific Heart Association
Peripheral arterial disease (PAD) involves the buildup of fatty deposits and plaque that block the flow of blood through arteries in the lower extremities. When there is a decrease in the blood supply to the legs, the most common symptom is pain or cramping when walking, also known as claudication. If left untreated, PAD could potentially lead to gangrene and amputation.
Peripheral Angioplasty is a procedure which is used to open narrowed arteries of the legs.
Under local anesthetic and through a tiny puncture in the groin area, a small balloon-tipped catheter is inserted into the affected artery and advanced to the site of the blockage. The balloon is inflated to flatten the fatty deposits and widen the artery. Then a stent — a small, metal tube or “scaffold” — is inserted to keep the artery open.
Now or Never
Atherosclerosis is a progressive disease. It can affect arteries supplying blood to heart, brain, limbs, and other organs of your body. Over time, the inner walls of the arteries become clogged with deposits composed of fat, cholesterol, fibrin (a clotting material found in the blood), and calcium. Accumulation of these materials decrease the blood supply to vital organs thus causing either a heart attack (if coronary arteries are obstructed), painful muscle cramping during exercise or even at rest (if a leg artery is obstructed) and stroke (if a neck artery is obstructed). Performing a timely Peripheral Angioplasty accompanied with positive life style changes prevents risks of having a heart attack, stroke, gangrene, and the morbidity and mortality associated with these conditions.
Decision to have Peripheral Angioplasty
Peripheral Angioplasty has revolutionized the treatment of Peripheral Vascular Disease. Implantation of stents during angioplasty procedure reduces the chances of re-blockage of the artery tremendously. Accompanying lifestyle changes can definitely reduce chances of further problems and complications.
Bioabsorbale (Dissolving) Stents
A stent that slowly dissolves into the body appears to be a safe and effective way of treating blocked coronary arteries. . If all the stent is gone, then stent clogging (thrombosis) would be less likely to occur. Bioabsorbale stents provide the mechanical scaffold whilst the artery heals and then disappear leaving a vessel similar to the original, with hopefully more normal fluid dynamics, compliance and endothelial function. This would allow the artery to remodel as it wills-without any problem of loss of apposition of the stent. The vessel would be more receptive to further treatment with either stents or surgery. These stents wouldn't interfere with diagnostic evaluations such as MRI and CT. Equally important, the technology offers the promise of doing away with vessels loaded up with multiple stents, the so-called full metal jacket, which has the potential to interfere with future coronary surgery.
One of the more speculative hypotheses with the bioabsorbable stents is that a stent that leaves nothing behind might prove useful in patients with vulnerable plaques/arteries. Rather than wait for the disease to advance to stenosis or plaque rupture, some experts envision the stent as preventive, which would expand use of the stents to more and more patients. Certain subsets of patients are currently deemed unsuitable for this new breakthrough in treating coronary artery disease. These include those with extensive calcified blockages and blockages at the side of branches that come off the main vessels.