Drug-Eluting Stents Found Effective at Preventing Major Amputations

It is generally accepted in the medical community that drug-eluting stents (DES) are helpful in restoring normal blood flow to the heart. In recent years, however, DES treatment has been applied with proven success in other contexts.

For example, consider a patient with peripheral vascular disease (PVD); an unfortunately common medical condition characterized by the occlusion of the arteries of the legs and arms. This disease is usually caused or exacerbated by other medical conditions such as diabetes, high cholesterol, high blood pressure, and kidney disease. People who smoke are at a much higher risk for developing PVD as well. It has been reported that as many as five million adults in the U.S. have PVD.

Patients with PVD tend to experience a gradual decrease in blood flow to their extremities. Over time, this can result in a complete interruption of blood and the development of necrotic tissue. In the past, once necrotic tissue was present, amputation was often the only available medical treatment.

Recent research suggests that DES treatment may be used effectively to prevent or reverse arterial occlusions in patients with PVD. According to an article published by Modern Medicine, researchers studied 106 patients who were treated with DES to restore blood flow in the lower extremities.

There were no procedural deaths, and 96 percent of the patients were discharged within 24 hours. The researchers found that the three-year cumulative incidence of amputation was 6 percent ± 2 percent, survival was 71 percent ± 5 percent, and amputation-free-survival was 68 percent ± 5 percent. Also, only 12 percent of patients who died had a previous major amputation. The target limb revascularization rate was 15 percent.

This study suggests that DES treatment can be effective at preventing major amputations. If you are facing the possibility of amputation as a result of PVD or another ischemic process, ask your doctor about angioplasty and DES treatment.

Contributing author: Jon Stefanuca

Bill Clinton’s stent procedure – what it’s all about.

On February 4, 2010, former President Bill Clinton underwent a surgical procedure to restore blood flow to one of his coronary arteries. According to reports, he had been experiencing chest pain for several days prior to his admission to Presbyterian Hospital in New York. During the hospital admission, imaging studies revealed that one of Clinton’s bypass grafts was occluded. This bypass graft was created during Clinton’s quadruple bypass surgery back in 2004.

To restore blood flow to Clinton’s coronary artery, the surgeons performed a procedure called angioplasty. Angioplasty is a surgical technique used to mechanically widen or enlarge an occluded blood vessel. In cardiac angioplasties, surgeons use balloons catheters. These catheters have a balloon at the tip. During cardiac angioplasty, this catheter is guided into the body and then into the affected blood vessel until the tip of the catheter reaches the blocked area of the blood vessel. At such time, the tip of the catheter is inflated, causing the lumen or the interior diameter of the blood vessel to expand. As the blood vessel is expanded, any fatty deposits on the interior wall of the vessel are crushed and compressed. Then, the balloon is deflated and removed. As a result of this process, the vessel regains blood flow. Sometimes, the surgeon will also install a metal coil or a stent into the affected blood vessel to prevent future narrowing or blockage.

Clinton was diagnosed with a blockage in one of the bypass grafts, which was created during his quadruple bypass surgery back in 2004. This graft serves as a surrogate blood vessel to reroute blood around a blockage in the coronary artery. Clinton’s surgery involved the ballooning of the graft and the installation of two stents to provide for long-term blood vessel support.