SIR: Stents Prevent Peripheral Arterial Disease-Related Amputation

SEATTLE, March 7 -- Angioplasty and stenting of small vessels below the knee are successfully staving off amputation among older patients with severe peripheral arterial disease (PAD), researchers said here.

Among 57 patients at the critical limb ischemia stage of PAD, 92% avoided amputation through two years of follow-up with the treatment, said Nael Saad, M.B., B.Ch., of the University of Rochester (N.Y.) Medical Center.

At one year, 85% of the blockages remained open and 77% remained open after two years, he reported at the Society of Interventional Radiology meeting.

Blockages in the pelvis and thigh have been treated with endovascular procedures for some time.

Until recently though, stenting systems were not small or flexible enough to safely reach the 2 to 3 mm arteries in the calf, said Brian F. Stainken, M.D., of the Roger Williams Medical Center in Providence, R.I., who moderated a press conference during which the study was discussed.

"We are seeing more and more patients as the population ages with this sort of problem," Dr. Stainken said, "and these sorts of techniques particularly in those patients who can't tolerate surgery represent a real attractive option."

Less invasive surgical options are limited, Dr. Saad said. "Because of their advanced condition and their disease status, they don't have a lot of surgical options other than possibly amputation. They don't have enough vein to act as a bypass graft, their arteries are too diseased to bypass to, and also they can't withstand the anesthesia needed for the surgery."