CMC debuts new PAD procedure

Earlier this month, surgeons at CMC became the first in New England to perform a radial approach to atherectomy — a treatment for peripheral artery disease (PAD). 

Published 10/23/2018

Published in the New Hampshire Union Leader

Earlier this month, surgeons at Catholic Medical Center became the first in New England to perform a radial approach to atherectomy — a treatment for peripheral artery disease (PAD). 

Drs. Yvon Baribeau and Patricia Furey performed the procedure at CMC’s state-of-the-art practice, Vein & Vascular Specialists in Bedford.

PAD is a disease that affects as many as 18 million Americans, but is believed to be widely under-diagnosed. It’s caused by plaque buildup in the arteries, which reduces blood flow and causes pain, mobility problems, and wounds that don’t heal. 

PAD most frequently occurs in the arteries in the leg.

“An atherectomy clears away plaque and prepares the artery for a balloon angioplasty or a stent to help restore blood flow,” a CMC news release states. “These minimally invasive procedures typically happen by inserting surgical tools through a catheter that’s placed in the femoral artery, located in the groin.”

Surgeons use a system called the Diamondback 360 Extended Length Peripheral Orbital Atherectomy Device from Cardiovascular Systems, Inc. to access the diseased artery by going through the wrist.

“This is a more comfortable procedure for the patient,” says Dr. Baribeau, a cardiothoracic and vascular surgeon with CMC’s New England Heart & Vascular Institute. “Going in through the wrist instead of the femoral artery is less invasive, presents fewer potential complications and allows for a quicker recovery time. This is an outpatient procedure and patients are able to walk less than three hours after it’s done.”

Previously, catheters used for PAD treatment weren’t long enough to reach the leg arteries from the wrist. CSI developed a longer device to allow radial (from the wrist) access for most patients. 

According to the news release, a small tool inserted through the catheter has a diamond-tipped crown which rotates inside the artery, scraping away plaque. It functions like an orbital sander, but is gentle on the arterial wall and preserves the healthy vessel tissue. 

Not everyone is appropriate for the radial approach, including those who are very tall and those who may have diseased arteries in the upper parts of their bodies. 

“Patients must also be committed to lifestyle changes, like eating healthy, exercising, and quitting tobacco, if they want to realize long-term vascular health,” says Dr. Furey, a vascular surgeon with the Heart & Vascular Institute. 

If left untreated, PAD, or hardening of the arteries, can lead to serious problems like organ damage or failure. 

“That’s why it’s so important to get diagnosed and treated as early as possible,” says Dr. Furey. “Pairing an atherectomy to clear plaque buildup with an angioplasty or stent to restore blood flow gives patients a good chance at restoring their health and avoiding those life-threatening complications.” 

“Hopefully,” adds Dr. Baribeau, “offering the most advanced, least invasive treatments in the region will help encourage people who are at risk for PAD to get the care they need. This really is a procedure that can vastly improve your health in a matter of hours.”