Stenting May Save Legs

Many with severe peripheral arterial disease can avoid amputation, researchers find

By Steven Reinberg
HealthDay Reporter

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TUESDAY, March 16 (HealthDay News) -- When angioplasty fails, patients with severe peripheral arterial disease may now have another option.

A drug-releasing stent placed in the blocked artery below the knee might re-establish blood flow, new research shows.

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Critical limb ischemia, the most severe form of peripheral arterial disease (PAD), causes more than 100,000 leg amputations in the United States each year. Now, researchers from Mount Sinai Medical Center in New York City say insertion of a stent can prevent many of these amputations.

"Traditional balloon angioplasty is plagued by high incidence failure, restenosis [recurrence] and inability to elevate the patient's symptoms," said lead researcher Dr. Robert A. Lookstein, associate director of Mount Sinai's division of interventional radiology.

Patients with critical limb ischemia have leg pain even when resting and sores that don't heal because of lack of circulation, Lookstein said. They are at risk of gangrene and amputation.

But placing a stent in the affected artery during angioplasty greatly improves these problems, Lookstein added. The drug-eluting stent keeps the narrowed artery open and releases a medication for several weeks after implantation, preventing the artery from closing again, he said.

"Patients with the least severe form of the [severe] disease, those with pain at rest, as well as the patients with minor skin infection of their legs, were able to avoid major amputation," he said.

But some patients with severe disease and those with gangrene still lost a limb, said Lookstein, who was scheduled to present the finding Monday at the Society of Interventional Radiology's annual meeting in Tampa, Fla.

For the study, Lookstein's team followed 53 patients with critical limb ischemia who had a total of 94 drug-eluting stents implanted to treat leg arteries that would not stay open after angioplasty alone. These are the same stents commonly used to open blocked coronary arteries.

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