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Endovascular treatments for peripheral artery disease and peripheral vascular disease Millions of Americans are threatened by peripheral artery disease (PAD). PAD (or PVD, peripheral vascular disease) is the leading cause of leg amputations in patients over 50 in the United States. Clearing blockages in leg arteries has always been a challenge because the blood vessels are small and have complex pathways.

Physicians on the medical staff at Texas Health are pioneering new techniques and using new technologies to get to these blockages and restore healthy blood flow. One device uses a tiny rotating blade no larger than a grain of rice to shave away sections of plaque that have built up on the artery wall. As the blade is advanced inside the artery, it collects the shaved plaque and removes it from the patient.

Cryoblation

Atrial fibrillation (AF), one of the most common cardiac arrhythmias seen by physician in the US, is a condition that causes the upper chambers of the heart to start and stop erratically. Patients who struggle with AF often have high blood pressure and structural heart disease. If left untreated, AF can cause rapid and irregular heart palpitations as well as lead to both stroke and death. Texas Health Fort Worth is the first hospital in Tarrant County to offer the Arctic Front® Cardiac CryoAblation Catheter system, the first and only cryoballoon that is FDA approved to treat drug refractory recurrent symptomatic paroxysmal AF. Artic Front® Cryoablation is a minimally invasive procedure that uses a balloon catheter system to deliver a freezing coolant instead of heat to make circumferential lesions around the pulmonary vein. In contrast to traditional heat-based ablation, the freezing technology significantly reduces the risk of damage to critical structures adjacent to the heart. The procedure allows for trained surgeons to restore normal function to the heart in a safer and more efficient manner.

Crossing Chronic Total Occlusions

Angioplasty and stent placements are some of the best tools available to open clogged peripheral arteries, but chronic total occlusions (CTO), which are total blockages of the blood vessel for at least 30 days, pose a tougher challenge. To use stents and angioplasty, physicians first have to get through the blockage with a guide wire. Physicians on the medical staff at Texas Health are investigating the effectiveness of minimally invasive technologies to treat these once-impenetrable blockages of peripheral arteries, and are putting them into practice where appropriate. Crossing the CTO and restoring blood flow to the patient’s lower leg greatly reduce the risk of amputation. New technologies to cross the CTO include a minimally invasive catheter system that channels through the blockage like a corkscrew, allowing doctors to further treat the condition. Other technologies include a type of catheter that utilizes high-frequency mechanical vibration to help breach or cross dense blockages, allowing for balloon angioplasty and stent placement.

Endovascular Embolization

A vascular malformation is a tangle of blood vessels that have clumped together, causing circulation problems. In some of these tangles, arteries are interconnected with veins called arteriovenous malformations (AVMs). The condition can cause dangerous bleeding in the brain, called an intracranial hemorrhage.

Today, physicians on the medical staff at Texas Health are using angiography and other imaging technologies to better see blood flow within the brain, providing critical information about the malformation. Interventional neuroradiologists on the medical staff at Texas Health are performing a procedure called endovascular embolization that involves the insertion of a catheter through an artery in the groin. The tube is guided up through the blood vessels to the site of the malformation, where a liquid similar to glue is used to clog the malformation and restore normal circulation. Embolization often is used in conjunction with microsurgical resection or radiosurgery.

Minimally Invasive Stroke Procedures