Emory Crawford Long Hospital is one of the first hospitals in the state to offer a new technology to treat patients with clogged arteries in the lower legs and feet--a condition known as peripheral vascular disease or PVD--offering patients a welcome alternative to amputation. Using a device inserted through a catheter into the groin, specialists shave away plaque inside the arteries and remove blockages as small as 1.5 millimeters (about the size of a grain of rice) that, in the past, have been too small to treat.
PVD, similar to coronary artery disease, causes cholesterol build-up in the legs and feet, leading to poor circulation in the lower extremities resulting in leg or foot pain. In severe cases, patients can even lose a limb because of lack of circulation.
"This new technology allows us to go into smaller vessels like those below the knee, as well as into the foot to remove plaque," says Khusrow Niazi, MD, assistant professor of medicine (cardiovascular diseases) at Emory University School of Medicine and cardiologist at the Carlyle Fraser Heart Center at Emory Crawford Long Hospital. "The prior technology limited us to only larger arteries in the legs. Successful removal of plaque improves blood flowÊto the foot in order to heal foot wounds, relieve pain and prevent amputation of feet and toes, all common complications of PVD," explains Dr. Niazi.
Because of its small size and unique design, the device, known as the MiniHawk Plaque Excision System, has the ability to efficiently and effectively remove blockages by shaving away plaque inside the tiny arteries of the foot, which supply blood to the toes. The device uses a tiny rotating blade to remove the plaque, collect it and then extract it from the patientÕs body with no pain to the patient. Unlike angioplasty, the device does not use a balloon to expand the artery and push aside the plaque. Before and after the procedure, contrast dye is injected into the artery to closely examine the blockage using a live X-ray. The patient is awake during the procedure and can walk out of the hospital the next day.
PVD affects over 12 million people in the United States. Symptoms of the disease often include severe pain, numbness (cold feet) and tingling or weakness in the legs and feet. When arteries are robbed of blood and oxygen, patients can develop a more severe stage of PVD known as Critical Limb Ischemia (CLI). Tissue in the foot and legs begins to die and discolor. Within one year of the onset of CLI, 25 percent of the patients will die and another 25 percent will undergo limb removal--a figure that has risen to more than 150,000 amputations per year.
"People who have pain in the legs or feet should be screened for PVD," says Dr. Niazi. "If they have blockages below the knee, then this new device will be helpful. We think it will be especially beneficial in diabetics and in patients with renal failure."
Dr. Niazi has done more than 500 plaque removal procedures with a similar device, the SilverHawk Plaque Excision System, which removes blockages from larger arteries in the legs. He has done three procedures using the MiniHawk, all of which were successful.
The MiniHawk is made by FoxHollow Technologies and is FDA-approved. Most insurance companies cover this plaque excision procedure.