June 1, 2005 — Doctors now use cold angioplasty to restore blood flow to the legs and relieve chronic leg pain. The procedure, where cold nitrous oxide inflates a balloon inside arteries to unclog them, is similar to the balloon angioplasty used to unclog coronaries.
MOUNTIAN VIEW, Calif.--A hot topic in science and technology is cold medicine. That may sound like a contradiction, but cold temperatures help kill tumors, settle down rapid heartbeats, and now the high-tech cold snap attacks deadly leg pain.
At this California hospital, doctors treat chronic leg pain with the chills. It's called CryoPlasty. It works something like balloon angioplasty around the heart.
"It eliminates the pain because there's now adequate blood supply, oxygen, nutrition to the muscular tissues of the leg," James Joye, an interventional cardiologist at El Camino Hospital in Mountain View, Calif., tells DBIS.
Cardiologists like Joye use cold nitrous oxide, or laughing gas, to inflate a balloon -- opening clogged arteries below the knee. The chilly gas doesn't hurt the artery, but it prevents scar tissue from forming. He says, "We are stunning the cells that normally would create the scar tissue and making them basically down-regulate, disappear."
CryoPlasty helped Karen Hudson, one of 10 million Americans with peripheral vascular disease, or PVD. She says, "I could walk, maybe, a short -- maybe a block or two before it became so uncomfortable I had to sit down."
Many PVD cases lead to surgery or amputation. Cryotherapy may help save limbs and lives since PVD is a red flag for heart disease.
Joye says, "They don't die typically because their legs hurt. They die from heart attacks, and they die from strokes and at a much higher frequency than regular patients."
Hudson says she never got cold feet. "I'm really amazed at -- with going in one day and having it done, and then, you know, you go home ... you can walk." ...And without pain.
The FDA approved CryoPlasty three years ago for surgery above the knee. This study is to see how well it works below the knee. There is hope that eventually it can be used to treat clogged arteries around the heart, too.
BACKGROUND: A new non-surgical therapy gently cools and opens leg arteries clogged with plaque, saving the patient from amputation. Essentially "angioplasty on ice," CryoPlasty therapy is now being offered at nearly 800 sites in the U.S., including most major hospitals.
HOW IT WORKS: To open up arteries clogged with plaque, doctors use a technique called angioplasty. The technique works very well, but it causes scarring of the artery wall. In traditional angioplasty, a catheter is used to guide a tiny balloon to the site of the arterial blockage. The balloon is then filled with saline, and this compresses the walls of the clogged artery to open it and allow blood to flow through. CryoPlasty therapy works in much the same way, but it uses nitrous oxide instead of saline to inflate the balloon and then cool it to -10 degrees Celsius. The body then opens the artery. This technique causes less scarring than traditional angioplasty.
ABOUT PAD: Peripheral artery disease is a condition that affects about 10 million people in the U.S. It often leads to severe blockage in the arteries, particularly in the lower leg. Such blockages reduce blood flow to the legs and feet, increasing the risk of infection, leg ulcers, gangrene and amputation. Those with PAD are also more at risk for other cardiovascular diseases, including heart attack and stroke.
THE STUDY: Researchers participated in Below the Knee Chill, an ongoing multi-center study at 30 leading hospitals across the U.S. It will test CryoPlasty therapy on 100 patients facing likely amputation of a foot or a leg within six months, due to severely clogged leg arteries.
THE RESULTS: Of the 22 patients studied so far, 100 percent were successfully treated with CryoPlasty: Their arterial blockages were 50 percent or less after CryoPlasty therapy. Eighty-three percent of arterial lesions treated with the technology remained open after nine months
The American Association of Physicists in Medicine contributed to the information contained in the TV portion of this report.
Note: This story and accompanying video were originally produced for the American Institute of Physics series Discoveries and Breakthroughs in Science by Ivanhoe Broadcast News and are protected by copyright law. All rights reserved.
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