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Patients are typically prescribed blood thinners, statins to lower cholesterol or anti-platelet medicines
A
device that consists of tiny, blow-up cushions is being used to widen
clogged-up arteries in the legs – and doctors believe it could work
better in the long term than current treatments.
The
device has been developed to treat peripheral artery disease (PAD),
which is like heart disease, except it occurs in the legs.
It
is caused by the build-up of fatty deposits, or plaque, in the artery
walls (known as atherosclerosis). This reduces the supply of blood to
the legs and feet, triggering symptoms such as pain in the calf
muscles, thighs or buttocks when walking or exercising.
The
poor circulation can also cause tissue to die, which may lead to
complications such as wounds or ulcers that won’t heal. Left untreated,
it could result in amputation.
It’s
estimated that 2.7 million people aged 55 or older have some degree of
PAD, and the condition can be a warning sign for cardiovascularÂ
disease, heart attack and stroke. If the arteries of the legs become
affected by atherosclerosis, so, too, might those that supply the heart
and brain.
Patients
are typically prescribed drugs such as blood thinners, statins to lower
cholesterol or anti-platelet medicines, such as aspirin and
clopidogrel, to prevent blood clots.
However,
some patients still require surgery to improve circulation. This
usually involves angioplasty, where a tiny balloon is inflated inside
the blood vessel to widen it. There is the risk of damaging the blood
vessel and dislodging plaque which can break away, causing a blockage.
Sometimes
the blood vessel can narrow again – a process known as restenosis. So
further treatment may be required, such as inserting a stent, a tiny
tube-like device, inside the blood vessel to hold it open.
If
angioplasty is performed on larger arteries, the success rates are
better: after four years, the blood vessel remains open in 60 to 80 per
cent of cases.
However, it doesn’t work as well for smaller arteries, with a success rate of 50 to 60 per cent.
The
new balloon is made up of a series of separate, pillow-shaped
compartments. It is inserted through the groin and pushed along the
blood vessel until it reaches the area that is narrowed.
The
balloon pillows are inflated individually, then deflated. A metal ring
restricts the amount by which each pillow can expand. The benefit of the
 new design is that the pressure from the balloon is spread across a
much wider area.
This
results in less stress on the artery, meaning it is less likely that
plaque will be dislodged and break away. The balloon is also coated in a
drug that reduces the build-up of fatty plaque in the future.
A device that consists of tiny, blow-up cushions is being used to widen clogged-up arteries
A
clinical trial with 60 people is underway at Auckland City Hospital,
New Zealand, and Universitats Herzzentrum Bad Krozingen, Germany. In a
previous study in the U.S., a form of the pillow balloon without aÂ
drug coating was tested on 350 patients, some of whom had advanced
per-ipheral artery disease and were at high risk of amputation.
Results show that affected limbs were preserved in 96 to 97 per cent of patients.
Commenting
on the technique, Professor Michael Horrocks, of the Royal College of
Surgeons, said: ‘This sounds like an interesting addition to the range
of drug-releasing stents available, particularly where the limb is
threatened and an amputation may become necessary.
‘The
short and long-term results of independent clinical trials are eagerly
awaited to assess the effectiveness of this new device in these
difficult clinical problems.’
?Meanwhile, scientists are testing whether injections of stem cells could be a treatment for peripheral artery disease.
In
a trial at the University of Texas, patients are being given injections
of stem cells – master cells that have the ability to grow into other
types of cells in the body.
Scientists
hope that the cells may repair damaged tissue and  restore blood flow
by stimulating the development of new blood vessels.
The 80 patients on the study will be given ten injections of stem cells taken from their bone marrow or a placebo.
The flow of blood in their leg and their pain levels will be monitored for a year.
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