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Added on Nov 14, 2006 | Filed Under:

One-Year Study Suggests Stents May Treat PAD and Prevent Restenosis

NEW ORLEANS, LA Today, at the American Heart Association meeting in Chicago, Ochsner Cardiology Fellow Dr. Arthur G. Grant, M.D., presented study findings that found drug-coated stents may be a feasible and safe treatment option to maintain blood flow through tiny clogged vessels in the lower leg. Treating clogged arteries in the lower leg is difficult due to the size of the arteries, plaque build up, and re-clogging frequency known as restenosis explains Dr. Grant. His study found that in 10 patients, the drug-coated mesh tubes, know as drug-eluting" stents, reduced the risk of restenosis in nine of the 10 participants. In previous studies, 50% of patients suffered restenosis. "Restenosis is a common problem associated with significant morbidity and mortality. This is an exciting first step toward solving this problem," says Grant. Dr. Grants ongoing study may also assist patients with peripheral arterial disease (PAD), the accumulation of plaque in the arteries that carry blood from the heart to the entire body. PAD in the legs, common in the older population, is an extremely painful condition that makes walking a short distance or standing difficult, and in severe cases can lead to amputation. PAD in the legs can be treated by surgery or angioplasty, which involves inflating a balloon in the clogged artery to flatten the plaque and restore blood flow - about 50 percent of the small arteries suffer restenosis. Additionally, patients with lower-leg PAD are often poor candidates for surgery, making minimally invasive stents a good alternative. Stents have been used for more than a decade to treat coronary artery disease. The metal devices are fitted over a balloon that is inflated to fit the stent into an obstructed artery. Recently, new stents are coated with drugs to prevent the growth of scar tissue that leads to restenosis. Drug-coated stents have dramatically reduced the frequency of restenosis and the need for repeat treatment. Since arteries below the knee are similar in size to coronary arteries, we chose to investigate the impact of drug-eluting coronary stents in these areas, explains Grant. Of the first 10 patients, one patient had claudication (leg pain and weakness due to poor blood flow) and nine had severe arterial narrowing at risk of amputation. Following the stent placement, nine have been complication-free for a year, while one patient developed a blood clot three weeks post-treatment and required emergency angioplasty to restore blood flow. "Obviously we need additional studies, but the initial results are encouraging," Grant said. "We have placed drug-eluting stents in several patients and continue to follow them in order to determine their outcomes."

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