New options for treating ‘vastly undiagnosed’ problem

TRAVERSE CITY – Much medical emphasis has been placed on cardiac vascular disease, but there are other vascular territories that also need public attention.

Approximately 10 million individuals nationwide are affected by Peripheral Vascular Disease (PVD). It occurs when blood vessels that carry blood from the heart to the rest of the body are narrowed or blocked by atherosclerotic plaque. Many who have this disease often go unnoticed or untreated.

"Of the patient population we see, we know that this is a vastly undiagnosed problem," says Roberto Corpus, MD, Interventional Cardiologist with Great Lakes Cardiology and co-chair of Munson's Vascular Department.

"What a lot of people don't realize is the disease in arteries outside the heart, especially the arms, legs and kidneys, can cause the same degree of problems as those in the heart. However, these are often not recognized."

Munson Medical Center is leading the way in treating this disease.

The hopsital has established a vascular department and is working toward creating a common endovascular suite for the performance of interventional procedures in a common environment. This will allow interventional physicians to use the same technical support and also allow them to share ideas and techniques.

The latest interventions for treating PVD can bring swift relief and are more cost-effective than surgery. Most procedures are performed on an outpatient basis or require only an overnight stay.

An example of a new device for plaque removal is the Silverhawk plaque excision system. It's an approach that mimics the traditional effects of surgical plaque removal.

The Silverhawk system received FDA approval for treatment of PVD in 2004. Munson was the first hospital in northern Michigan to offer it.

"What this catheter does is shave the artery," Corpus explained. "A blade rotates very quickly as you shave the plague…it gets collected in what is called the nose cone…you don't leave anything behind."

A catheter is advanced from a small puncture in the arm or leg to the site of the blockage, where the treatment is applied to the arterial wall. The plaque is collected in the tip of the device and removed.

Techniques available to treat PVD include the use of balloon catheters, stents, atherectomy and thrombolytic therapy (inserting the catheter to the site of the clot and dissolving it with drugs). All these treat the built-up plaque or clot by either removing it, compressing it or displacing it.

"Historically, a vascular surgeon has been responsible for doing open by-pass procedures on vascular patients and interventional radiologists have done the catheter-based procedures," said Daniel Dall'Olmo, MD, Chief of Interventional Radiology and co-chair of Munson's Vascular Department.

"In late 1980 to early 1990, it was clear that the future of vascular disease was toward less invasive intervention."

In addition to Dall'Olmo, the Interventional Radiology team includes three more board-certified, fellowship-trained specialists: Frederick Brodeur, MD; Michelle Lung, MD; and C. Paul Williams, MD.

The instances of peripheral disease vary by age and several risk factors – the top being age. Of patients over the age of 70, about one in three will have peripheral vascular disease, Corpus said.

Symptoms of PVD include pain while walking or a tired feeling in the legs or arms. Hypertension can also be a symptom.

Left untreated, PVD can lead to pain during rest, ulceration or gangrene, leading to amputation. BN