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Published on September 08, 2014

MU Surgeon Uses New Minimally Invasive Technology to Treat Artery Disease

COLUMBIA, Mo. ― Todd Vogel, M.D., chief of vascular surgery at University of Missouri Health Care, is using new catheter-based imaging technology that for the first time allows physicians to see inside a vessel while treating peripheral arterial disease.

Peripheral arterial disease is a common circulatory problem in which plaque builds up inside arteries of the legs, blocking blood flow. The initial symptoms include leg pain or cramping when walking. The disease can progress to include leg pain at night while at rest. As the condition gets worse, patients are not able to walk for long periods of time, and often struggle to walk even short distances. Eventually, it can lead to gangrene of the foot or leg as the oxygen-starved tissue dies. Amputation of the limb is the only option once that level of damage occurs.

The new technology being used at MU Health Care is a minimally invasive approach that uses optical coherence tomography to capture real-time 3-D images from within an artery. Guided by this imaging system, surgeons can precisely maneuver a catheter to the site of a total blockage. Spiral flutes at the tip of the catheter tunnel through the blockage, enabling a guide wire to pass across the blocked or closed part of the artery. A therapeutic device such as a balloon or stent can then be used to reopen the artery and restore blood flow to the patient’s limb.

“It’s the first time we’ve been able to look inside an artery and use internal imaging to guide the catheter precisely to the best site of the blockage,” said Vogel. “Previously, we had to rely on a combination of X-ray imaging, as well as touch and feel, to locate and penetrate a complicated blockage or closure in an artery. By visualizing the blockage from the perspective of the catheter rather than the top view that we get with traditional X-ray imaging, we have increased opportunities to cross through these difficult blockages. The patients who benefit most are those who would otherwise require an open bypass or even amputation.

“There are several other advantages to using this new system,” Vogel said. “Because the procedure is minimally invasive, we are able to decrease operative risks for those with additional complex medical conditions, procedural times are shorter, and in most cases patients don’t need general anesthesia. Recovery times are also shorter, and radiation exposure is minimized or completely eliminated because X-ray imaging is not needed.”

According to the Centers for Disease Control and Prevention, more than eight million Americans have peripheral arterial disease. Often, people regard the symptoms as just a sign of aging, and they are unaware of the severity of the disease, Vogel said. For Vogel and the vascular surgery team at MU Health Care, the month of September is an important time to raise awareness of the condition.

“Amputation of a leg is a difficult decision that is made by more than 100,000 patients each year,” Vogel said. “The goal of using this new technology is that by increasing blood flow to the lower extremities, we hope to reduce the risk of amputation for many patients, and because this technology is minimally invasive, we can reduce the need for traditional open bypass surgeries.”

To learn more about peripheral arterial disease, its symptoms and treatments, please visit