COLD LASER SAVES LEGS
About one million people in the United States suffer from a condition called critical limb ischemia, or CLI. It's common among people with diabetes and leads to about 100,000 amputations a year. Now, a procedure that's changing that statistic.
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At 77, Rene Heredia has had his share of frustration.
Most of that frustration came from dealing with the pain in his legs.
Rene Heredia
Suffered severe pain
"I swear, the pain was so intense. I don't wish that pain to my worst enemy."
Rene has critical limb ischemia -- a painful condition that blocks blood flow in his legs. A simple cut can have devastating consequences.
Daniel Garnic, M.D.
Cardiovascular & Interventional Radiologist
Glendale Memorial Hospital
Glendale, CA
"It leads from a minor scrape or cut to what could end up as an amputation."
In fact, the condition leads to about 100,000 amputations every year. Smoking, diabetes and high cholesterol raises the risk.
Now, doctors are saving legs with this, a cold laser that can eat through plaque.
Daniel Garnic, M.D.
"At the tip of the laser, the light energy touches the plaque and vaporizes it."
It's called clirpath and it lets doctors work through blockages they couldn't get through before. This image shows three blocked areas of the leg. After clirpath, the increased blood flow is obvious. Studies show the laser can save 93 percent of limbs from being amputated.
Daniel Garnic, M.D.
"This is the best thing that's come down in peripheral vascular disease, I think, in the last 20 years."
It worked for Rene.
Rene Heredia
"No more complaints. No more pain."
With his pain gone, Rene now has time to deal with life's smaller frustrations.
BACKGROUND: Critical limb ischemia (CLI) is the most severe form of peripheral arterial disease. CLI is a condition where plaque builds up in the leg arteries, causing a blockage in blood flow. It can be extremely painful and lead to the development of foot wounds and amputation. Risk factors for CLI include smoking, diabetes and high cholesterol. About 1 million people in the United States have CLI, and each year, it causes nearly 100,000 amputations. The best way to prevent CLI is to stop smoking, maintain a healthy diet, exercise, and keep cholesterol in check.
CURRENT TREATMENTS: The two mainstays of treating CLI have been bypass surgery and balloon angioplasty. With bypass surgery, doctors can reroute blood from above a blockage in the leg artery to an area below the blockage using another artery or a graft. However, the procedure is invasive and because these are patients who have such severe disease, surgery is often not an option. With balloon angioplasty, doctors enlarge narrowed arteries by inflating a balloon on the tip of a catheter. However, doctors say only about 25 percent of people with blockages in the small arteries can be treated with standard angioplasty. Many patients have arteries that are so blocked, they simply cannot be crossed with the standard guidewire used in these procedures.
LASER AWAY BLOCKAGES: Now, there's a third option for patients with CLI -- a laser called CLiRpath. CLiRpath stands for Cool Laser Revascularization for Peripheral Artery Therapy. In this procedure, doctors use a cool laser to clear out blockages in the leg arteries. The laser is inserted into the artery where, as Daniel Garnic, M.D., from Glendale Memorial Hospital in Los Angeles, says, "It vaporizes [the plaque], converts it to carbon dioxide and water vapor." The laser allows doctors to get through blockages they could not have penetrated before. By clearing out the plaque, blood flow is restored. Dr. Garnic says, "If we can re-establish just one vessel to the foot, then that is going to increase the flow possibly 100 or 200 percent."
Studies of CLiRpath show the procedure can save more than 90 percent of limbs from amputation. Dr. Garnic says, "The biggest benefit for patients is that they can save a limb. If they can keep mobile, they can stay active. Staying active helps them to maintain their well-being. This is the best thing that's come down in peripheral vascular disease, I think, in the last 20 years."
NOT A CURE-ALL: Doctors say the laser may not be a permanent fix for all. First, major lifestyle changes need to be adopted by the patients. They need to eliminate risk factors such as smoking and high cholesterol from their life to avoid another blockage. Some arteries may re-occlude within six to 12 months after the CLiRpath procedure, so patients typically need to see their doctors three, six and 12 months after the procedure to monitor progress. The laser is FDA-approved for this condition, and most insurance companies should cover the cost of the procedure.
Ken Hunter
Praco
6 Nor Tejon Street - 4th Floor
Colorado Springs, CO 80903
1-800-231-0978
www.clirpath.com
Copyright © 2005 Ivanhoe Broadcast News, Inc.
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