St. John’s first in area to offer new procedure for treating severe leg pain

A new FDA-approved device is being used at St. John's Hospital to treat the painful symptoms of peripheral arterial vascular disease (PVD). A new nonsurgical treatment is used to clean out large amounts of plaque that clog the arteries of the legs and cause pain. The specialized procedure is only performed in a select number of cities by physicians like St. John's cardiologist Robert Merritt, M.D.

"It cuts the plaque with a blade and stores it in the housing, so it can be extracted," Merritt explains. "This prevents plaque from breaking off and going downstream."

Previously, PVD was treated with angioplasty or stents, both of which stretch arteries and push plaque against artery walls to improve blood flow through the arteries. PVD causes severe pain because plaque build-up causes arteries to become narrow or blocked. Merritt says people with PVD can go undiagnosed for years because they often attribute the pain to aging and try to learn to live with it. The disease can have devastating effects, he warns.

"It's a disease that affects arteries throughout the body. Some people suffer for years and lose mobility or in extreme cases lose a limb or receive organ damage. This procedure provides another option for treating them and improving their quality of life," Merritt says.

People who have high blood pressure, diabetes and high cholesterol are more at risk of developing PVD. Symptoms may include limb pain, intestinal pain and eating problems.
St. John's interventional cardiologists, interventional radiologists, cardiovascular surgeons and general vascular surgeons have teamed to create a unique multidisciplinary approach to the treatment of arterial vascular disease. An advisory team of these physicians representing physicians from multiple specialties meet weekly to focus on early identification of individuals at risk for vascular disease and plan coordinated treatment approaches between cardiology, radiology and surgery.

Bringing multiple specialists together has provided an overall more comprehensive treatment of arterial vascular disease. These specialists work closely together to coordinate the delivery of optimal and often cutting-edge technology to St. John's patients.

"The traditional lines of referral for vascular diseases use all of these specialists and we realized it's best for the patient to bring all of those groups together to best understand the population. Our approach allows us to bring 12-15 highly trained subspecialists to the playing field," says Kelvin Van Osdol, M.D., St. John's cardiology chair. "PVD serves as a marker for heart attack and stroke and the population is so under treated and undiagnosed. We're building on education for this disease because most people would like to be treated medically before needing bigger interventions."

"Ultimately, patients benefit greatly by bringing together specialists with their unique expertise and excellence in treating patients with PVD. Our goal is total vascular care for our patients and we think we've accomplished this with a dedicated, coordinated and cooperative approach," Van Osdol said.

Phyllis Fields of Lebanon was one of Merritt's first patients to benefit from the new procedure. She has been treated for vascular disease for five years with surgery and medicine. In 2002 she required balloon angioplasty on an artery in her right leg.

When pain intensified in her left leg, Merritt had to perform surgery. He was able to use the new device in Fields’ right leg that had narrowed again after the 2002 procedure. She is still recovering, but is optimistic doctors have her condition more under control.

"My legs were in so much pain. I was ready to have something done. Everyone at St. John's was so wonderful. I would recommend to people that they have something done and not live with the pain," Fields says.

St. John's PVD advisory team members include: Robert Merritt, M.D., cardiologist; Julie Alford, M.D., radiologist; Victor Phillips, M.D., vascular surgeon; Clyde Redmond, M.D. cardiovascular surgeon and Rick Williams, M.D., family practice physician.

What is PVD?

Peripheral vascular disease (PVD) sometimes referred to as peripheral artery disease (PAD), is a condition which most commonly affects arteries in the legs. PVD occurs when harmful plaque buildup causes a narrowing of the artery, eventually constricting normal blood flow to the body's extremities.

PVD can be extremely painful, debilitating and can eventually lead to amputation and death. An ankle brachial index (ABI) is used to measure the rate of blood pressure in the ankle to that in the arm. A lower pressure in the ankle may indicate PVD. This is a simple, non-invasive test, which can be done in the doctor's office.