Drug-coated stents may prevent complications of peripheral Arterial Disease
According to new research presented at the Society of Interventional Radiology’s 38th Annual Scientific Meeting in New Orleans, it seems that one of the most common complications of diabetes, namely PAD (peripheral arterial disease), can now be prevented by using drug-eluting stents. These stents enable blood flow in the arteries and prevent the installation of peripheral ischemia.
PAD, or peripheral arterial disease, refers to the blockage of an artery from the systemic circulation, such as the leg arteries. Because of diabetes or atherosclerosis, these arteries become obstructed and gradually various signs and symptoms occur such as pain, cramps, tingling, burning, etc.. In some cases, occlusion may occur suddenly and the pain is acute and severe. Local consequences of ischemia (interruption of blood flow in an artery) refers to the loss of hairiness, low local temperature, atrophic nails and can go up to amputation.
Robert A. Lookstein, MD, FSIR, lead researcher and chief of interventional radiology at Mount Sinai Medical Center in New York, said the prevalence of PAD is on the increase due to aging population, diabetes and obesity. He said that patients with PAD that are not candidate for surgery may opt for minimally invasive procedures. Lookstein estimated that up to 20% of Americans age 65 of North or older suffer from this condition.
The most severe form of PAD is critical limb ischemia, which means that the arteries are almost completely blocked. Besides pain that occurs when walking, patients with PAD may also have different wounds that will not heal or heal very slowly. If left untreated, PAD can lead to amputation.
So far the results of this new method of treatment for critical limb ischemia have shown that stents are safe and effective. This form of therapy helps to relieve pain and prevent amputation. According to Lookstein, these special stents can maintain open arteries thus enable a good blood flow.
To verify the efficacy and safety of this new method of treatment, researchers conducted a retrospective study that included 107 patients with critical limb ischemia. They were evaluated and 171 drug-eluting stents were placed in blocked arteries. According to the study, their effectiveness was not constant during the entire follow-up period: 90% were functional after 6 months, after a year-84% were open, and after 2 years only 70% were functional. There was no case of amputation in patients with critical limb ischemia treated in early stages. An alternative for patients who are not candidates for surgery is minimally invasive balloon angioplasty. But long-term success rate is low when small arteries are interested because of restenosis.
The advantage of these new stents is that they prevent restenosis because the drug impregnated is released long time. Lookstein said that this new method is superior to balloon angioplasty. “It’s safe, it’s durable and the outcomes is spectacular. The vast majority of patients were able to avoid amputation and dramatically improve their quality of life,” he added.