Local Physician First in the Region to Use New Procedure to Treat Peripheral Vascular Disease

AN OVERVIEW: PERIPHERAL VASCULAR DISEASE

Nearly 10 million patients in the United States suffer from peripheral vascular disease, yet only about 4 percent are diagnosed. Peripheral vascular disease (PVD) affects one in ten people over age 50. Unfortunately, many individuals who experience leg pain or numbness dismiss it as a normal part of aging and don’t seek help.

The condition occurs when the arteries that carry blood to the arms or legs become narrowed or clogged with plaque, interfering with normal blood flow. The pain can sometimes be very severe, often limiting even casual walking. Some 100,000 people undergo amputations each year due to end stages of the disease. Others face open bypass surgery in the legs.

R. Stefan Kiesz, M.D., an interventional cardiologist practicing at Northeast Methodist Hospital in San Antonio, is the first physician in a ten-state area to use a new FDA-approved device that actually cleans out large amounts of plaque from clogged arteries in the leg. "We've had some patients with peripheral vascular disease who couldn't even walk from their beds to the bathroom because of the pain in their legs, but after undergoing this procedure, they can walk without pain," said Dr. Kiesz, president of San Antonio Endovascular Heart Institute. "By extracting the plaque, we open up the arteries so blood can flow freely and provide oxygen to the extremities."

Symptoms of PVD include painful cramping in the leg, hip or buttock area when walking (pain stops when you rest), numbness, tingling or weakness in the leg, and cold legs or feet. In severe cases, patients experience a burning or aching pain in the foot or toes while resting or may develop a sore on the foot or leg that doesn't heal. Persons at highest risk for PVD are over age 50, smokers, and persons who lead a sedentary lifestyle, have diabetes, high blood pressure or high cholesterol or are overweight.

THE PROCEDURE

The SilverHawk Plaque Excision System--the only device of its kind available--uses a rotating blade to shave plaque from artery walls. The catheter acts somewhat like a lawnmower, first cutting the plaque, and then like a trash compactor, compressing it into the nosecone of the device and removing it. The new device is important because it gives physicians a way to treat PVD below the knee with lasting results. Plaque tends to build up along the entire length of the artery, making it hard to use stents or angioplasty because they generally target a small section of the artery. Even when stents or angioplasty are used, these procedure stretch the artery and push plaque up against artery walls, and arteries tend to re-narrow with time. The Silverhawk cleans out the plaque instead of pushing it up against the wall. Also, plaque excision is a minimally invasive procedure, routinely performed on an outpatient basis.

Northeast Methodist Hospital, where Dr. Kiesz performs the procedure, is taking part in a national registry that will analyze plaque collected by the SilverHawk device to determine if potential genetic markers may help better predict cardiovascular risk.

STORY IDEA

With advance notice, Dr. Kiesz is available for interviews on the new procedure, and we have identified a patient who had the procedure and is willing to be interviewed. An illustration of the procedure is available on CD.

If you are interested in doing a story, please phone Shirley Wills at 822-2378 or 365-4488(cell) or JoAnn King, 575-0171 or 917-7916 (pager). For media assistance during the weekend, please phone Methodist Hospital, 575-4000, and ask for the public relations representative on call.