Research shows angioplasty and stenting can prevent amputation and restore blood flow in the lower extremities of patients with severe critical limb ischemia and gangrene (tissue loss). At eighteen months, the tiny arteries below the knee remained open, with a ninety-one percent success rate, thus preventing amputation. This success rate was consistent in all patients who were consecutively enrolled over a six-year period of time. The blockages were caused by peripheral arterial disease (PAD), "hardening of the arteries," the same disease which can lead to heart attack and stroke. The smaller blood vessels below the knee are more difficult to treat due to their size (3mm) and are more prone to reclog than larger vessels. The research was presented recently at the Society of Interventional Radiology's Annual Scientific Meeting.

"This study shows that with angioplasty and stenting, we can restore blood flow through the smallest vessels in the legs and keep them open long-term, saving these patients from life-altering amputation," says lead author Nael Saad, M.D., interventional radiologist, University of Rochester Medical Center, Rochester, New York. "Aggressive interventional therapy should be considered in all patients as a first option. In general, the long-term clinical results are comparable to by-pass surgery in the leg using a longer, more complex graft, but with a much lower risk of morbidity and mortality."

About the Study
Forty-seven patients had eighty-one blockages treated that were below the knee. Sixty-six percent were men with a mean age of seventy-three. The patients had the following risk factors that are also indicative of PAD:

. 85% smoking history . 53% kidney disease
. 62% cardiac history . 53% obese
. 91% hypertensive . 60% hyperlipidemia
. 55% diabetic
Primary patency using angioplasty and/or stenting was seventy-five percent at three months and fifty-five percent at 18 months. By re-treating the artery that became re-clogged, the artery remained open, saving the limb in ninety-one percent at 18 months follow-up. Abstract 111 can be found at www.SIRmeeting.org.

About Peripheral Arterial Disease
Peripheral arterial disease (PAD), also known as peripheral vascular disease (PVD), is a very common condition affecting 12-20 percent of Americans age sixty-five and older. PAD develops most commonly as a result of atherosclerosis, or "hardening of the arteries," which occurs when cholesterol and scar tissue build up, forming a substance called plaque inside the arteries that narrows and clogs the arteries. PAD is a systemic disease - clogging in one area of the body (legs) indicates clogging is occurring in other parts of the body (heart).

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