Intervene before CLI threatens limbs

The goals of treating peripheral artery disease (PAD) are to manage symptoms and slow down the progression to critical limb ischemia (CLI). Lifestyle changes such as weight loss or smoking cessation may help prevent disease progression. Prescription medications may also help manage symptoms. But in many cases, bypass surgery or percutaneous transluminal angioplasty (PTA) with or without a stent is necessary to restore blood flow in order to prevent amputation.

The primary goal of treating CLI is to relieve ischemic rest pain, heal ulcers or gangrene, and prevent limb loss (amputation) by restoring at least one unobstructed line of blood flow to the foot. But due to the many challenges in treating these patients (multi-vessel disease, calcium, small vessel diameter, etc.), there are few treatment options available today.

It is estimated that 2 to 3.4 million PAD patients in the U.S. have progressed to a diagnosis of CLI, the most severe form of the disease.1

Current treatment options have limitations

Physicians and patients are increasingly choosing endovascular treatment, including angioplasty, for the treatment of PAD and CLI. By inserting a small balloon into the diseased section of the artery, the lumen can be expanded to improve blood flow. However, the arterial wall may become damaged—or torn—during this process (dissection).

Dissections may obstruct blood flow both immediately and in the long-term if they don’t heal. Dissections in the arteries demonstrate high restenosis and reintervention rates. Lesions with dissections have a target lesion revascularization (TLR) rate 3.5-fold higher compared with lesions without.2 It’s important to address them when they occur, to maintain vessel integrity and improve patency.

Stents are often used to treat dissections but have limitations of their own.

For informational purposes only. You should always consult with your doctor when seeking medical advice or considering treatment.

References

  1. Yost M, The Sage Group 2017. [Press Release]
  2. Kokkinidis DG, Armstrong EJ. Emerging and future therapeutic options for femoropopliteal and infrapopliteal endovascular intervention. Intervent Cardiol Clin 2017; 279-295.