Understanding Peripheral Artery Disease Before Treatment
Peripheral artery disease (PAD) involves the narrowing of the arteries in the lower extremities due to atherosclerosis. In atherosclerosis, plaques of fatty material are deposited on the inner walls of the blood vessels, making them narrower and leading to pain and potential loss of function in the legs and feet. PAD is not rare — data shows that roughly six percent of U.S. adults over 40 have some degree of PAD. That equates to almost eight million people.
At Premier Cardiology, we use laser atherectomy as one option for treating PAD. In laser atherectomy, a catheter that emits high-energy light unblocks the artery. The procedure is effective and safe.
What is laser atherectomy?
There are different methods of atherectomy, or clearing a blood vessel blocked by plaque buildup. At Premier Cardiology Consultants, we like laser atherectomy as an option because it is minimally invasive and effective. Whereas other methods of atherectomy use cutting blades to bore through the obstruction, laser atherectomy uses laser energy to vaporize the blockage and return blood flow
Are there Different Types of Mechanical Atherecotomy?
In addition to laser atherectomy, there are four types of mechanical atherectomy devices that use cutting tips to bore through the blockage. These are named for the type of device:
- Orbital – This is a new aged method is used to treat symptomatic peripheral artery disease. It uses the diamondback 360 to remove plaque from within a diseased arterial segment; as the crown rotates, the debulking area expands, and with increments in speed, the area increases further.
- Directional. – Directional Atherectomy allows more blood to flow to the heart muscle and ease the pain caused by blockages in the coronary arteries. This procedure is minimally invasive.
Peripheral artery disease (PAD) Symptoms
When a blood vessel becomes increasingly blocked by the buildup of plaque this can lead to the following symptoms:
- Pain and numbness in the legs and feet
- Coldness in your lower leg or foot
- A change in color in your legs
- Walking or climbing stairs becomes painful, but some people falsely believe it is simply a result of aging
- Increases your risk of infection in the affected limbs
If this blockage remains without treatment, the end result in the most serious cases can be the need for foot or even leg amputation.
What are the risks of laser atherectomy?
The risks of laser atherectomy are low. There is some possibility of heat damage to arterial walls, but this is rare. Blood flow can slow in the area, but this can be adjusted with medicines during the procedure. In about 40 percent of patients (only 20 percent of those with stents placed), the opened artery narrows again within six months after your procedure. These patients may need to have the procedure repeated.
The laser atherectomy procedure
You will be awake, but sedated for comfort during the procedure. We thread a thin guide wire into the blocked artery through a needle inserted into a blood vessel in your groin. Dye is injected into the artery to allow us to track the laser atherectomy catheter as it is moved through the artery to the site of the blockage. At that point, the laser emits its light energy and essentially vaporizes the blockage inside the artery. This returns normal blood flow down through the leg and into the foot. In some cases, we will then insert a stent at the location to reduce the likelihood of another blockage reforming. We then remove the catheter.
laser atherectomy Recovery
After your procedure, you will rest in bed for 12 to 24 hours, usually returning home the next day. You can resume normal activities in just a day or two. We may choose to temporarily place you on blood-thinning medication. Strenuous exercise should be avoided for up to one month.