Riverside Offers New Treatment For Peripheral Arterial Disease

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Peripheral Arterial Disease

Gary Ansel, MD, of Riverside Methodist Hospital became the world's first physician on Wednesday, Aug. 29, to treat a common form of peripheral arterial disease (PAD) with a new device that improves outcomes, speeds recovery and may minimize the risk of complications.

Ansel successfully implanted the GORE VIABAHN Endoprosthesis with Heparin Bioactive Surface, a stent graft designed to open blockages in the superficial femoral artery in the thigh, into William Doup, 69, of Bellefontaine, Ohio.

"This is a whole different approach to the problem," said Ansel, an interventional cardiologist at the McConnell Heart Hospital at Riverside. "It may change everything we do."

Eight to 12 million Americans ages 50 and older have PAD, characterized by clogged arterial walls in the legs. These blockages are the same as those found in the heart and neck and can result in death from stroke and heart attack.

A blockage from plaque build-up in the thigh's large superficial femoral artery "is one of the most common types of PAD," Ansel said. "It affects up to 10 percent of the population over the age of 70."

Stents are small, metal coil or mesh tubes commonly inserted into arteries to reduce vessel narrowing and improve circulation.

The device is made by W.L. Gore & Associates in Flagstaff, Arizona, a company known for its consumer product Gore-Tex. "It's the same material that's in my rain suit for golf," said Doup, the pioneering patient.

The U.S. Food and Drug Administration approved its use in August to relieve hardening of the thigh artery.

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The cloth combines mechanical and a pharmacologic approach to opening leg blockage. The Gore-Tex fabric stops tissue from growing inside the tube and has the blood thinning medication Heparin as part of the device lining.

The Gore-Tex keeps the Heparin anchored to its surface, allowing the medication to interact with the blood for years. "It's like putting a stain retardant covering on furniture," Ansel said.

The stent placement is a less invasive alternative to bypass surgery that requires an incision or several incisions over the entire length of the thigh with a four- to six-week recovery.

"Many patients had to undergo bypass surgery to treat these blockages. Now we can treat the same population non-surgically," Ansel said. "Safety goes with the fact that this is less invasive. For example, the chance of infection goes down from 20 to 1/2 percent."

Ansel inserted the device in Doup's leg in 20 minutes through a puncture the size of a ballpoint pen tip.

"I checked in for the procedure at 6 a.m. and went home the same day at 12:45 p.m.," Doup said.

He expects to return to work and his beloved golf one week later.

"I've been telling everybody that I'm a star," Doup said. "I love being a part of a medical breakthrough."

Riverside is one of the nation's top centers for the treatment of peripheral arterial disease, performing more than 2,000 procedures a year.

"As the population ages, we are seeing dramatic increases in PAD," Ansel said. "It's often a disease among people who eat the wrong things and don't exercise. For the foreseeable future, it looks like nothing better is going to replace this Gore stent" -- the only FDA-approved stent graft for the superficial femoral artery.

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